Effects of sling and voluntary constraint during constraint-induced movement therapy for the arm after stroke: a randomized, prospective, single-centre, blinded observer rated study

2012 ◽  
Vol 26 (11) ◽  
pp. 990-998 ◽  
Author(s):  
Maciej Krawczyk ◽  
Marta Sidaway ◽  
Anna Radwańska ◽  
Joanna Zaborska ◽  
Renata Ujma ◽  
...  
Keyword(s):  
Movement Therapy ◽  
Motor Deficits ◽  
Stroke Patients ◽  
Voluntary Activity ◽  
Massed Practice ◽  
Constraint Induced Movement Therapy ◽  
Significant Difference ◽  
Quality Of Movement ◽  
Rivermead Motor Assessment

Objective: To determine whether a combination of constraint-induced movement therapy and physiotherapy in stroke patients using different constraint regimens (sling versus voluntary constraint) changes or reduces motor deficits, the amount of functional use of the arm and whether the effects of treatment continue after 12 months. Design: Forty-seven stroke patients were stratified and randomly divided into intensive physiotherapy programmes focused on regaining arm functions. Setting: Neurorehabilitation Unit of IInd Department of Neurology at Institute of Psychiatry and Neurology in Warsaw. Subject: Patients were randomly allocated to: the sling-constraint group ( n = 24) or to the voluntary-constraint group ( n = 23). Interventions: Massed practice with the paretic arm (5 hours/day for 15 consecutive working days). Sling-constraint group had their arm immobilized in a hemi-sling during therapy. In addition, individual, 1-hour physiotherapy sessions were conducted in both groups. Main measures: Rivermead Motor Assessment (RMA) Arm scale, (0–15), Motor Activity Log – Quality of Movement (MAL-QOM) (0–5 for 30 daily tasks). Results: There was no significant difference between groups after therapy (MAL-QOM mean change for sling group 0.78, SD = 0.46 and for voluntary-constraint group 0.84, SD = 0.48; P = 0.687). All treated patients retained mean gains in real-world arm use (MAL-QOM) mean scores after 12 months follow-up compared with posttreatment values but there was no significant difference between groups (comparison of estimated mean change of MAL-QOM stated 0.23. 95% confidence interval = −0.04–0.50). Conclusion: Voluntary activity constraint in the intact arm is equivalent to sling, standard constraint during massed practice of paretic arm.

scholarly journals Application of Low-Intensity Modified Constraint-Induced Movement Therapy to Improve the Affecter Upper Limb Functionality in Infantile Hemiplegia with Moderate Manual Ability. Case Series

2020 ◽  
Author(s):  
Rocío Palomo-Carrión ◽  
Rita-Pilar Romero-Galisteo ◽  
Elena Piñero-Pinto ◽  
Purificación López-Muñoz ◽  
Helena Romay-Barrero ◽  
...  
Keyword(s):  
Upper Limb ◽  
Case Series ◽  
Movement Therapy ◽  
Low Intensity ◽  
Constraint Induced Movement Therapy ◽  
Case Series Study ◽  
Quality Of Movement ◽  
Prospective Case Series ◽  
Quest Scale

Objective: To assess the functionality of the affected upper limb in children diagnosed with hemiplegia aged between 4 and 8 years after applying low-intensity modified constraint-induced movement therapy(mCIMT). Methods: Prospective case series study. A mCIMT protocol was applied for five weeks, with two hours of containment per day. The study variables were: quality of movement of the upper limb, spontaneous use, participation of the affected upper limb in activities of daily living, dynamic joint position, grasp-release action, grasp strength, supination and extension elbow movements. Four measurements were performed, using the QUEST scale, the SHUEE Evaluation, a hand dynamometer and a goniometer. Results: The sample was composed of 8 children with moderate manual ability. Statistically significant differences were detected in all the studied variables (p<0.05). The greatest increase occurred in spontaneous use from assessment 1-4 (p = 0.01), reaching 88.87% active participation in bimanual tasks. The quality of movement of the upper limb obtained a significant value due to the increase in dissociated movements and grasp (p = 0.01). Conclusion: A low dose (50 hours) of mCIMT increased the functionality of children diagnosed with congenital hemiplegia between 4 and 8 years of age with moderate manual ability.

scholarly journals Application of Low-Intensity Modified Constraint-Induced Movement Therapy to Improve the Affected Upper Limb Functionality in Infantile Hemiplegia with Moderate Manual Ability: Case Series

Children ◽  
2020 ◽  
Vol 7 (9) ◽  
pp. 127
Author(s):  
Rocío Palomo-Carrión ◽  
Rita-Pilar Romero-Galisteo ◽  
Elena Pinero-Pinto ◽  
Purificación López-Muñoz ◽  
Helena Romay-Barrero ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Upper Limb ◽  
Case Series ◽  
Movement Therapy ◽  
Low Intensity ◽  
Constraint Induced Movement Therapy ◽  
Case Series Study ◽  
Quality Of Movement ◽  
Pre Treatment

Objective: To assess the functionality of the affected upper limb in children diagnosed with hemiplegia aged between 4 and 8 years after applying low-intensity modified Constraint-Induced Movement Therapy (mCIMT). Methods: Prospective case series study. A mCIMT protocol was applied for five weeks, with two hours of containment per day. The study variables were quality of movement of the upper limb, spontaneous use, participation of the affected upper limb in activities of daily living, dynamic joint position, grasp–release action, grasp strength, supination and extension elbow movements. Four measurements were performed, using the quality of upper extremity test (QUEST) scale, the Shriners Hospital for Children Upper Extremity Evaluation (SHUEE) Evaluation, a hand dynamometer and a goniometer. Results: The sample was composed of eight children with moderate manual ability. Statistically significant differences were detected in all the studied variables (p < 0.05) between the pre-treatment and post–treatment results (Week 0–Week 5), except for upper limb dressing, putting on splints and buttoning up. In the first week, the changes were statistically significant, except for protective extension, grasp strength, grasp–release and all functional variables (level of functionality and participation of the patient’s upper limbs) in the SHUEE Evaluation (p > 0.05). The greatest increase occurred in spontaneous use from Assessment 1 to Assessment 4 (p = 0.01), reaching 88.87% active participation in bimanual tasks. The quality of movement of the upper limb exhibited a significant value due to the increase in dissociated movements and grasp (p = 0.01). Conclusion: A low dose (50 h) of mCIMT increased the functionality of children diagnosed with congenital hemiplegia between 4 and 8 years of age with moderate manual ability.

Bobath Concept versus constraint-induced movement therapy to improve arm functional recovery in stroke patients: a randomized controlled trial

2012 ◽  
Vol 26 (8) ◽  
pp. 705-715 ◽  
Author(s):  
Burcu Ersoz Huseyinsinoglu ◽  
Arzu Razak Ozdincler ◽  
Yakup Krespi
Keyword(s):  
Therapy Group ◽  
Controlled Trial ◽  
Functional Independence Measure ◽  
Movement Therapy ◽  
Functional Independence ◽  
Stroke Patients ◽  
Constraint Induced Movement Therapy ◽  
High Level ◽  
Concept Group

Objective: To compare the effects of the Bobath Concept and constraint-induced movement therapy on arm functional recovery among stroke patients with a high level of function on the affected side. Design: A single-blinded, randomized controlled trial. Setting: Outpatient physiotherapy department of a stroke unit. Subjects: A total of 24 patients were randomized to constraint-induced movement therapy or Bobath Concept group. Intervention: The Bobath Concept group was treated for 1 hour whereas the constraint-induced movement therapy group received training for 3 hours per day during 10 consecutive weekdays. Main measures: Main measures were the Motor Activity Log-28, the Wolf Motor Function Test, the Motor Evaluation Scale for Arm in Stroke Patients and the Functional Independence Measure. Results: The two groups were found to be homogeneous based on demographic variables and baseline measurements. Significant improvements were seen after treatment only in the ‘Amount of use’ and ‘Quality of movement’ subscales of the Motor Activity Log-28 in the constraint-induced movement therapy group over the the Bobath Concept group ( P = 0.003; P = 0.01 respectively). There were no significant differences in Wolf Motor Function Test ‘Functional ability’ ( P = 0.137) and ‘Performance time’ ( P = 0.922), Motor Evaluation Scale for Arm in Stroke Patients ( P = 0.947) and Functional Independence Measure scores ( P = 0.259) between the two intervention groups. Conclusions: Constraint-induced movement therapy and the Bobath Concept have similar efficiencies in improving functional ability, speed and quality of movement in the paretic arm among stroke patients with a high level of function. Constraint-induced movement therapy seems to be slightly more efficient than the Bobath Concept in improving the amount and quality of affected arm use.

Effects of constraint-induced movement therapy on motor cortex organization in chronic stroke patients

NeuroImage ◽  
1998 ◽  
Vol 7 (4) ◽  
pp. S24
Author(s):  
J. Liepert ◽  
H. Bauder ◽  
M. Sommer ◽  
W.H.R. Miltner ◽  
C. Dettmers ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Movement Therapy ◽  
Chronic Stroke ◽  
Stroke Patients ◽  
Constraint Induced Movement Therapy

Comparison of two types of Constraint-Induced Movement Therapy in chronic stroke patients: A pilot study

2009 ◽  
Vol 27 (6) ◽  
pp. 675-682 ◽  
Author(s):  
Anne Barzel ◽  
Joachim Liepert ◽  
Kerstin Haevernick ◽  
Marion Eisele ◽  
Gesche Ketels ◽  
...  
Keyword(s):  
Pilot Study ◽  
Movement Therapy ◽  
Chronic Stroke ◽  
Stroke Patients ◽  
Constraint Induced Movement Therapy

scholarly journals Unimanual Intensive Therapy with or without Unaffected Hand Containment in Children with Hemiplegia. A Randomized Controlled Pilot Study

2020 ◽  
Vol 9 (9) ◽  
pp. 2992
Author(s):  
Rocío Palomo-Carrión ◽  
Elena Pinero-Pinto ◽  
Sara Ando-LaFuente ◽  
Asunción Ferri-Morales ◽  
Elisabeth Bravo-Esteban ◽  
...  
Keyword(s):  
Pilot Study ◽  
Upper Extremity ◽  
Upper Limb ◽  
Intensive Therapy ◽  
Randomized Controlled ◽  
Upper Limb Function ◽  
Constraint Induced Movement Therapy ◽  
Quality Of Movement ◽  
Quest Scale

Children with hemiplegia have lower spontaneous use and quality of movement in the affected upper limb. The modified constraint-induced movement therapy (mCIMT) is applied to improve the affected upper limb function. The objective of this study was to study the efficacy of unaffected hand containment to obtain changes in the function of the affected upper limb after applying two unimanual therapies. A randomized controlled pilot study was performed with 16 children diagnosed with congenital infantile hemiplegia, with eight children randomized in each group (average age: 5.54 years; SD: 1.55). mCIMT and unimanual therapy without containment (UTWC) were applied, with a total of 50 h distributed in five weeks (two h/per day). Two assessments were performed (pre- and post-treatment) to evaluate the affected upper limb spontaneous use, measured with the Shiners Hospital Upper Extremity Evaluation (SHUEE), and the quality of movement, measured with the Quality of Upper Extremity Skills Test (QUEST scale). The progression of the variables was different in both groups. The results are expressed in the median of the improvement percent and interquartile range (IQR). The spontaneous use analysis showed an improvement percent of 31.65 (IQR: 2.33, 110.42) in the mCIMT group with respect to 0.00 (IQR: 0.00, 0.00) in the UTWC group. The quality of movement increased in the mCIMT and UTWC groups, 24.21 (IQR: 13.44, 50.39), 1.34 (IQR: 0.00, 4.75), respectively and the greatest increase was obtained in the grasp variable for both groups. The use of unaffected hand containment in mCIMT would produce improvements in the affected upper limb functionality in children with hemiplegia (4–8 years old) compared to the same protocol without containment (UTWC).

Comparison of FMS tests between female and male volleyball players with possible implications on volleyball performance

2020 ◽  
Author(s):  
Maja Ban ◽  
Tomislav Đurković ◽  
Nenad Marelić
Keyword(s):  
Effect Size ◽  
Transition Period ◽  
Male And Female ◽  
Significant Difference ◽  
Volleyball Players ◽  
Quality Of Movement ◽  
Almost All ◽  
Straight Leg Raise ◽  
Push Up

Purpose: The main goal of this study is to determine possible differences in the range and quality of movement between senior male and female volleyball players of HAOK Mladost. Methods: Respondents, all right-handed and healthy, were members of the senior volleyball team of HAOK Mladost (female n=24, male n=17). The testing was conducted during the transition period, between the first and second competition period. We used seven tests, all part of standard FMS protocol: Deep Squat (DS), Hurdle Step (HS), In-Line Lunge (ILL), Shoulder Mobility (SM), Active Straight Leg Raise (ASLR), Trunk Stability Push-up (TSPU), Rotary Stability (RS), with 12 measured variables (left and right side for five bilateral tests plus DS and TSPU). Educated staff at the Faculty of Kinesiology, University of Zagreb con-ducted the testing. The examination of significance of the differences between senior male and female volleyball players was conducted by using the nonparametric Mann-Whitney U test. Results: Statistical analysis showed significant difference in three tests: In – Line Lunge Left (ILLL), z= -2,11, p=0,03, with moderate effect size (r=0.33), Active Straight Leg Raise Left (ASLRL), z= -2,58, p=0,01, with moderate to strong effect size (r=0.4) and Stability Push-up (TSPU) z= -3,68, p=0,00, with strong effect size (r=0.58). Conclusion: Statistically significant difference was determined in the range and quality of movement in three measured variables. Male volleyball players achieved better results in two tests: In-Line Lunge Left (ILLL) and Stability Push-up (TSPU). That addresses to a higher ability to keep the balance during lunges (reaction on short balls during reception or defence phase of the game) and considerably higher ability to maintain the stability of the trunk in the transfer of force from the upper extremities to the lower (during block) and vice versa (during spike). It is interesting to note that female volleyball players achieved a significantly better rating in the Active Straight Leg Raise Left (ASLRL) test, suggesting a better flexibility of the left hamstrings and better right hip mobility which enables higher capacity in performing el-ements which require extension, which include almost all volleyball elements (hitting, serve receive and transition into offense, defence and transition into counterattack and blocking, smashing and jump serve).

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