Posts Tagged upper-extremity function

[Abstract] Effectiveness of Bilateral Arm Training for Improving Extremity Function and Activities of Daily Living Performance in Hemiplegic Patients

Background

Bilateral movement therapy, which encourages simultaneous use of the limbs on both the affected and nonaffected sides, is known to help in motor function recovery in hemiplegic patients. However, studies on the effectiveness of bilateral arm training for improving upper limb function and activities of daily living (ADL) performance in hemiplegic stroke patients are lacking. The present study investigated the effectiveness of bilateral arm training for improving upper limb function and ADL performance in hemiplegic stroke patients.

Methods

The study included 30 hemiplegic stroke patients. The patients were randomly divided into an experimental group (n = 15) and a control group (n = 15). All patients received a uniform general occupational therapy session lasting 30 minutes 5 times a week for 8 weeks. The experimental group received an additional session of bilateral arm training lasting 30 minutes, and the control group received an additional session of general occupational therapy lasting 30 minutes. The Fugl-Meyer assessment (FMA), Box and Block Test (BBT), and modified Barthel index (MBI) were used for evaluation.

Results

In both the experimental and control groups, the FMA, BBT, and MBI scores were significantly higher after the intervention than before the intervention (P <.05). The changes in the FMA, BBT, and MBI scores were greater in the experimental group than in the control group (P <.05).

Conclusions

Bilateral arm training along with general occupational therapy might be more effective than occupational therapy alone for improving upper limb function and ADL performance in hemiplegic stroke patients.

Source: Effectiveness of Bilateral Arm Training for Improving Extremity Function and Activities of Daily Living Performance in Hemiplegic Patients – Journal of Stroke and Cerebrovascular Diseases

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[Abstract] Functional outcome, Rehabilitation, Upper extremity function

Abstract

Introduction: Paretic upper limb in stroke patients has a significant impact on the quality of life. Modified Constraint Induced Movement Therapy (mCIMT) is one of the treatment options used for the improvement of the function of the paretic limb.

Aim: To investigate the efficacy of four week duration mCIMT in the management of upper extremity weakness in hemiparetic patients due to stroke.

Materials and Methods: Prospective single blind, parallel randomized controlled trial in which 30 patients received conventional rehabilitation programme (control group) and 30 patients participated in a mCIMT programme in addition to the conventional rehabilitation programme (study group). The mCIMT included three hours therapy sessions emphasizing the affected arm use in general functional tasks, three times a week for four weeks. Their normal arm was also constrained for five hours per day over five days per week. All the patients were assessed at baseline, one month and three months after completion of therapy using Fugl-Meyer Assessment (FMA) score for upper extremity and Motor Activity Log (MAL) scale comprising of Amount of Use (AOU) score and Quality of Use (QOU) score.

Results: All the 3 scores improved significantly in both the groups at each follow-up. Post-hoc analysis revealed that compared to conventional rehabilitation group, mCIMT group showed significantly better scores at 1 month {FMA1 (p-value <0.0001, es0.2870), AOU1 (p-value 0.0007, es0.1830), QOU1 (p-value 0.0015, es0.1640)} and 3 months {FMA3 (p-value <.0001, es0.4240), AOU3 (p-value 0.0003, es 0.2030), QOU3 (p-value 0.0008, es 0.1790)}.

Conclusion: Four weeks duration for mCIMT is effective in improving the motor function in paretic upper limb of stroke patients.

Source: JCDR – Functional outcome, Rehabilitation, Upper extremity function

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[Abstract] A Comparison of the Effect According to Type of Electromyography-triggered Neuromuscular Electrical Stimulation on the Upper Limb Function and Activities of Daily Living in Stroke Patients: A Prospective, Randomized Controlled Pilot Trial

Abstract

Objective :This study aimed at investigating the effect of two types of electromyography-triggered neuromuscular electrical stimulation on the upper limb function of the affected side and activities of daily living in stroke patients.

Methods :A randomized controlled study was conducted for 20 patients within 6 months of occurrence of a subacute stroke. The patients were divided into two groups as follows: those treated with electromyography-triggered neuromuscular electrical stimulation (EMG-NMES), and those treated with mental imagery training combined with EMG-NMES (MIT EMG-NMES), for 30 minutes a day, 5 days a week, for 4 weeks. For the assessment of upper limb function, the Fugl-Meyer Assessment (FMA) and Wolf Motor Function Test (WMFT) were used, and for the assessment of daily living activities, the Modified Barthel Index (MBI) was used.

Results :After four weeks of intervention, the MIT EMG-NMES-treated group showed statistically significant improvement in the FMA and WMFT (p<.01), and improvement in the MBI, particularly in each of the self-care scores, with a statistical significance (p<.05). The EMG-NMES-treated group showed significant improvement in wrist movement on the FMA and in the upper limb function in the WMFT (p<.05). There was no statistically significant improvement in the total MBI, except in the self-care score (p<.05).

Conclusion :This study suggests that both the MIT EMG-NMES and EMG-NMES are beneficial in improving the upper limb function and activities of daily living in patients after an acute stroke.

Source: :: Journal of Korean Society of Occupational Therapy ::

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[Abstract] Effect of Constraint Induced Movement Therapy v/s Motor Relearning Program for Upper Extremity Function in Sub Acute Hemiparetic Patients – a Randomized Clinical Trial

Background

Motor impairment after stroke is common, following damage to areas of the brain normally involved in the planning and execution of motor commands. Impaired motor control of the upper extremity is one of the most frequent consequences of stroke.

Objectives

To determine the effect of CIMT and MRP on upper limb function and to compare the effect of both in sub-acute hemiperatic patients.

Method

45 participants were randomly allocated into group A and B. Group A received CIMT technique. The unaffected extremity was restrained for 80 percent of working hours and task oriented training was given for affected extremity for 3 hours daily for 14 days. Group B received the motor relearning program for 14 days. Functions of upper limb were assessed using Nine Hole Peg Test, Motor Activity Log and Fugal Meyer Performance measured at the beginning and after completion of the intervention.

Result

The results of the present study showed statistical significant improvement in MAL (p=0.001) and FMS (p=0.031) in the CIMT group. The MRP group showed significant improvement in MAL (p=<0.001).

Conclusion

Both CIMT and MRP are found effective in improving upper extremity function in patients; however CIMT was more effective than MRP.

Source: Indian Journals

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[ARTICLE] Comparison of Grip and Pinch Strength in Adults with Dexterity Limitations to Normative Values – Full Text PDF

Abstract

Upper extremity function, which includes manual dexterity, plays an important role in one’s ability to perform activities of daily living. Dexterity may be reduced for a variety of reasons such as age, injury or disease. Understanding the capabilities of these users is critical to the effective design of products to meet their needs. While normative dexterity data is available for healthy adults, none has been compiled for people with dexterity limitations. The purpose of this study was to measure grip strength, key pinch strength and tip pinch strength in users with limited dexterity and compare them to adult norms. Average strength values were lower in all tests in men and women. It was observed that the dominant hand was strongest in each test in women but not always in men. No strong correlation between age and hand strength was observed. The sample size in this study was small so specific results are hard to generalize. The emergences of clear trends that differ from healthy norms indicate that a wider study may be fruitful.

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Source: Comparison of Grip and Pinch Strength in Adults with Dexterity Limitations to Normative Values

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[ARTICLE] Effects of a 12-hour neuromuscular electrical stimulation treatment program on the recovery of upper extremity function in sub-acute stroke patients: a randomized controlled pilot trial – Full Text PDF

Abstract

[Purpose] This study investigated the effects of a 12-hour neuromuscular electrical stimulation program in the evening hours on upper extremity function in sub-acute stroke patients.

[Subjects and Methods] Forty-five subjects were randomized to one of three groups: 12-hour neuromuscular electrical stimulation group (n=15), which received 12 hours of neuromuscular electrical stimulation and conventional rehabilitation for the affected upper extremity; neuromuscular electrical stimulation group (n=15), which received 30 min of neuromuscular electrical stimulation and conventional rehabilitation; and control group (n=15), which received conventional rehabilitation only. The Fugl-Meyer assessment, Action Research Arm Test, and modified Ashworth scale were used to evaluate the effects before and after intervention, and 4 weeks later.

[Results] The improvement in the distal (wrist-hand) components of the Fugl-Meyer assessment and Action Research Arm Test in the 12-hour neuromuscular electrical stimulation group was more significant than that in the neuromuscular electrical stimulation group. No significant difference was found between the two groups in the proximal component (shoulder-elbow) of the Fugl-Meyer assessment.

[Conclusion] The 12-hour neuromuscular electrical stimulation group achieved better improvement in upper extremity motor function, especially in the wrist-hand function. This alternative therapeutic approach is easily applicable and can be used in stroke patients during rest or sleep.

Full Text PDF [485K]

via Effects of a 12-hour neuromuscular electrical stimulation treatment program on the recovery of upper extremity function in sub-acute stroke patients: a randomized controlled pilot trial.

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[ARTICLE] The effect of mirror therapy on upper-extremity function and activities of daily living in stroke patients – Full Text PDF

[Purpose] The purpose of this study was to examine the effects of mirror therapy on upper-extremity function and activities of daily living in chronic stroke patients.

[Subjects and Methods] Fifteen subjects were each assigned to a mirror therapy group and a sham therapy group. The Fugl-Meyer Motor Function Assessment and the Box and Block Test were performed to compare paretic upper-extremity function and hand coordination abilities. The functional independence measurement was conducted to compare abilities to perform activities of daily living.

[Results] Paretic upper-extremity function and hand coordination abilities were significantly different between the mirror therapy and sham therapy groups. Intervention in the mirror therapy group was more effective than in the sham therapy group for improving the ability to perform activities of daily living. Self-care showed statistically significant differences between the two groups.

[Conclusion] Mirror therapy is effective in improving paretic upper-extremity function and activities of daily living in chronic stroke patients.

via The effect of mirror therapy on upper-extremity function and activities of daily living in stroke patients.

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[ARTICLE] The effect of mirror therapy on upper-extremity function and activities of daily living in stroke patients – Full Text PDF

[Purpose] The purpose of this study was to examine the effects of mirror therapy on upper-extremity function and activities of daily living in chronic stroke patients.

[Subjects and Methods] Fifteen subjects were each assigned to a mirror therapy group and a sham therapy group. The Fugl-Meyer Motor Function Assessment and the Box and Block Test were performed to compare paretic upper-extremity function and hand coordination abilities. The functional independence measurement was conducted to compare abilities to perform activities of daily living.

[Results] Paretic upper-extremity function and hand coordination abilities were significantly different between the mirror therapy and sham therapy groups. Intervention in the mirror therapy group was more effective than in the sham therapy group for improving the ability to perform activities of daily living. Self-care showed statistically significant differences between the two groups.

[Conclusion] Mirror therapy is effective in improving paretic upper-extremity function and activities of daily living in chronic stroke patients.

via The effect of mirror therapy on upper-extremity function and activities of daily living in stroke patients.

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[ARTICLE] The effects of modified constraint-induced movement therapy combined with trunk restraint in subacute stroke: a double-blinded randomized controlled trial

…These results suggest that mCIMT combined with trunk restraint is more helpful to improve upper-extremity function than mCIMT only in subacute stroke patients with moderate motor impairment…

via The effects of modified constraint-induced movement therapy combined with trunk restraint in subacute stroke: a double-blinded randomized controlled trial.

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