Efficacy of Constrained Induced Movement Therapy Versus Bilateral Arm Training on Upper Extremity Functional Outcomes in Stroke Patients

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Efficacy of Constrained Induced Movement Therapy Versus Bilateral Arm Training on Upper Extremity Functional Outcomes in Stroke Patients, ABDULALIM ATTEYA, WALEED T. MANSOUR, EBTESAM M. FAHMY and YOUSSEF M. EL BALAWY

 

Abstract
Background and Purpose: Recovery of motor function after stroke may depend on balance of activity of neural network involvingthe affected and the unaffected motor cortices. Modified constrained induced movement therapy and bilateral arm training share similar key therapeutic elements (mass and repetitive practice with specific techniques), and both target to improvement of the affected upper limb. The aim of the study was to compare the effect of these two techniques on improving upper extremity function in stroke patients.
Patients and Methods: Thirty male ischemic stroke patients with age ranged between 45-55 years. Patients were divided randomly into three equal groups. Group I received modified constrained induced movement therapy in addition to a selected physical therapy program. Group II received bilateral arm training in addition to a selected physical therapy program. Group III received the selected physical therapy program. Motor function of the upper extremity and gross manual dexterity were recorded using action research arm test and box and blocks test respectively.
Results: The results showed statistically very highly significant increase of the mean value of the action research arm test score of the affected upper limb post treatment within each group. (p=<0.0001 in GI, p=0.0001 in GII and p=0.007 in GIII) and Comparing between each pair of the three groups post treatment revealed that there was a statistically non-significant difference between GI and GII (p=0.143) while a very highly significant difference between GI and GIII (p=0.0001) and a highly significant difference between GII and GIII (p=0.008) post treatment. Also, there was a statistically very highly significant increase in BBT scorepost treatment within each group. (p=<0.0001in GI, p=0.0001 and p=0.0018 in GIII)and comparingbetween each pair of the three groups post treatment revealed that there was a statistically very highly significant difference in the mean value of BBT score between GI and GII (p=0.001) and between GI and GIII (p=0.0001) while there was a statistically highly significant difference between GII and GIII (p=0.006) post treatment.Conclusion: Bothmodified constrained induced movement therapy and bilateral arm training improves upper extremity function in hemipareticpatients with more superiority of modified constrained induced movement therapy on improving hand dexterity.

 

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