Increasing the delivery of upper limb constraint‐induced movement therapy post‐stroke: A feasibility implementation study

2020 ◽  
Vol 67 (3) ◽  
pp. 237-249 ◽  
Author(s):  
Annie McCluskey ◽  
Louise Massie ◽  
Gillian Gibson ◽  
Lisa Pinkerton ◽  
Ana Vandenberg
2013 ◽  
Vol 27 (2) ◽  
pp. 31-38 ◽  
Author(s):  
Marta Sidaway ◽  
Edyta Czernicka ◽  
Arkadiusz Sosnowski

StreszczenieNeuroplastyczność jest zjawiskiem powszechnym w działaniu układu nerwowego, a samoistne i spontaniczne zdrowienie jest normą we wczesnym okresie poudarowym. Zmiany plastyczne leżą u podstaw przywracania funkcji po uszkodzeniu mózgu. Reprezentacje czuciowe i ruchowe pól korowych mogą być modyfikowane przez dopływ bodźców ze środowiska. Odpowiednio dobrane strategie postępowania fizjoterapeutycznego mają wpływ na spontaniczną neuroplastyczność. Przedstawiono podstawowe założenia działań terapeutycznych mających korzystny wpływ, na omawiane zjawisko reorganizacji układu nerwowego oraz uczenia się kontekstualnego, szczególnie w odniesieniu do zagadnienia Terapii Ruchem Wymuszonym Koniecznością. Opisano protokół Tauba dotyczący tej terapii oraz stanowiący jej podwalinę zespół wyuczonego nieużywania. Przybliżono zagadnienie shapingu i praktyki zadaniowej (ćwiczeń zadaniowych). Głównym celem opisywanej terapii jest przywrócenie spontanicznego i automatycznego wykorzystania kończyny niedowładnej w czynnościach dnia codziennego.Na zjawisko plastyczności istotny wpływ mają: wzbogacone środowisko, odległość czasu od zachorowania, liczba powtórzeń zadań ruchowych oraz znajomość wykonywanych czynności co potwierdzają dowody naukowe.Prawidłowo prowadzona terapia pozwala przenieść osiągnięte umiejętności poza ściany kliniki i przyczynia się do funkcjonalnej niezależności pacjentów.


2009 ◽  
Vol 24 (6) ◽  
pp. 929-933
Author(s):  
Taichi KURAYAMA ◽  
Anna WATANABE ◽  
Minami TAKAMOTO ◽  
Nami SHIGETA ◽  
Yuki HASEGAWA ◽  
...  

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Kai Diederich ◽  
Verena Quennet ◽  
Henrike Bauer ◽  
Wolf-Rüdiger Schäbitz ◽  
Clemens Sommer ◽  
...  

Background and Purpose Both application of granulocyte-colony stimulating factor (G-CSF) and constraint-induced movement therapy (CIMT) have been shown to improve recovery after experimental stroke. The aim of the present study was to determine whether concurrent or sequential combination of both therapies will further enhance the therapeutic benefit and whether specific modifications in the abundance of various neurotransmitter receptors do occur. Methods Adult male Wistar rats were subjected to photothrombotic ischemia and assigned to the following treatment groups (n=20 each): (1) ischemic control (saline); (2) CIMT (CIMT between post-stroke day 2 and 11; (3) G-CSF (10μg/kg G-CSF daily between post-stroke day 2 and 11 (4), combined concurrent group (CIMT plus 10μg/kg G-CSF daily between post- stroke day 2 and 11; (5) combined sequential group (CIMT between post-stroke day 2 and 11 and 10μg/kg G-CSF daily between post-stroke day 12 and 21, respectively). Rats were functionally tested before and up to 4 weeks after ischemia. Quantitative receptor autography was performed for NMDA, AMPA and GABAA receptors. Results Significant improvement of functional outcome was seen in all groups treated with G-CSF alone and in either combination with CIMT, while CIMT alone failed to enhance recovery. Infarct sizes and remaining cortical tissue did not differ in the various treatment groups. Failure of significant benefit in the CIMT group was associated with a shift towards inhibition in perilesional and remote cortical regions. Conclusions Our findings unveil G-CSF as the key player for enhanced recovery after experimental stroke, preventing a shift towards inhibition as seen in the solitary CIMT group.


Children ◽  
2020 ◽  
Vol 7 (11) ◽  
pp. 248
Author(s):  
Rocío Palomo-Carrión ◽  
Helena Romay-Barrero ◽  
Rita-Pilar Romero-Galisteo ◽  
Elena Pinero-Pinto ◽  
Purificación López-Muñoz ◽  
...  

Modified constraint-induced movement therapy (mCIMT) is efficient at improving upper limb non-use. The experiences of families and children with mCIMT could allow researchers to understand how it influences their day-to-day life and to improve the function of the affected upper limb without altering family life and avoiding frustration. In this qualitative study, we aimed to collect the experiences of parents and their children (aged 4–8 years) who did mCIMT at home regarding the application of low-intensity modified constraint-induced movement therapy to improve the affected upper limb functionality in infantile hemiplegia with moderate manual ability. Individual semi-structured interviews were performed to obtain insights into their experience with mCIMT. The experiences of parents and children were described in thematic sections. Eight children with hemiplegia (six years, standard deviation, SD: 1.77) and their parents were asked about their experiences after applying 50 h of mCIMT at home. Three main themes emerged from the children’s interview data: (1) the experience of wearing the containment in the modified constraint-induced movement therapy (CIMT) intervention, (2) the reaction to performing the therapy at home with his/her family, and (3) learning of the affected upper limb. In the parents’ interview data, there were two main themes: (1) the difficulty of executing an intensive therapy protocol (mCIMT: 50 h) at home and (2) the feeling of not wanting to finish the intervention. The experiences of the parents and their children regarding mCIMT allowed us to understand the facilitators and barriers that affect the execution of mCIMT at home, and this understanding allows us to improve its future application.


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