Constraint-induced movement therapy for upper extremities in stroke patients

Sirtori, Valeria; Corbetta, Davide; Moja, Lorenzo; Gatti, Roberto

doi:10.1002/14651858.cd004433.pub2

Cited by 125 publications

(87 citation statements)

References 118 publications

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“…Nevertheless, the immobilization procedure used in the present work was also designed to reproduce in healthy subjects, for a short period, an already developed neuro-rehabilitative protocol, such as the constraint-induced movement therapy (CIMT). CIMT is a current approach to stroke rehabilitation that implies the massed practice of the affected arm by restraining, through immobilization, the unaffected limb (Langhorne et al, 2009;Sirtori et al, 2009). Stroke is a classical model of an unbalanced activity of the two M1s supported by an abnormal stronger interhemispheric communication from the intact to the lesioned hemisphere (Hummel and Cohen, 2006).…”

Section: Relevance Of the Present Findingsmentioning

confidence: 99%

Use-Dependent Hemispheric Balance

Avanzino¹,

Bassolino²,

Pozzo³

et al. 2011

J. Neurosci.

103

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In the human brain, homologous regions of the primary motor cortices (M1s) are connected through transcallosal fibers. Interhemispheric communication between the two M1s plays a major role in the control of unimanual hand movements, and the strength of this connection seems to be dependent on arm activity. For instance, a lesion in the M1 can induce an increase in the excitability of the intact M1 and an abnormal high inhibitory influence onto the damaged M1. This can be attributable to either the disuse of the affected limb or the overuse of the unaffected one. Here, to directly investigate cortical modifications induced by an abnormal asymmetric use of the two limbs, we studied both the excitability of the two M1s and transcallosal interaction between them in healthy subjects whose right hand was immobilized for 10 h. The left "not-immobilized" arm was completely free to move in one group of participants (G1) and limited in the other one (G2). We found that the non-use reduced the excitability of the left M1 and decreased the inhibitory influence onto the right hemisphere in the two groups. However, an increase in the excitability of right M1 and a deeper inhibitory interaction onto the left hemisphere were evident only in G1. Thus, modifications in the right M1 were not directly produced by the non-use but would depend on the overuse of the "not-immobilized" arm. Our findings suggest that the balance between the two M1s is strongly use dependent.

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Section: Relevance Of the Present Findingsmentioning

confidence: 99%

Use-Dependent Hemispheric Balance

Avanzino¹,

Bassolino²,

Pozzo³

et al. 2011

J. Neurosci.

103

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“…Previous studies of recovery of upper extremity function have investigated the effects of active, repetitive, and functional activities in post-stroke patients. The studies used constraintinduced movement therapy, robot-assisted movement, and electromyography-trigged neuromuscular electrical stimulation [6][7][8] . However, these therapeutic approaches mainly focus on fine motor skills in distal extremities, not gross motor skills in proximal extremities, even they have been reported to provide benefits for chronic stroke patients, the necessary elements for correct scapular movement, which is often linked to proper initiation and recruitment, are impaired in stroke patients 4) .…”

Section: Introductionmentioning

confidence: 99%

Effects of Scapular Stabilization Exercise on Function of Paretic Upper Extremity of Chronic Stroke Patients

Song¹

2013

J Phys Ther Sci

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Abstract.[Purpose] The purpose of this study was to investigate the therapeutic effects of scapular stabilization exercise on function of the upper extremity of individuals with chronic hemiparetic stroke.[Subjects] Eleven chronic hemiparetic stroke patients participated in a scapular stabilization exercise program conducted in the sitting position for 30 min per session, 5 days per week, for 4 weeks. We used 3 clinical assessments: the Manual Function Test, the Berg Balance Scale, and the Modified Barthel Index.[Results] Manual Functional Test Scores for the paretic upper limb significantly improved after the scapular stabilization exercise program. However, Manual Function Test scores for the non-paretic upper limb did not significantly improve after the scapular stabilization exercise program. The Berg Balance Scale and the Modified Barthel Index scores did not significantly improved after scapular stabilization exercise program.[Conclusion] The results of this study suggest that scapular stabilization exercise can improve the function of the paretic upper extremity of individuals with chronic stroke. However, scapular stabilization exercise did not affect balance or basic daily activities.

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“…4 In Western medicine, treatment added in standard rehabilitation in the early postacute phase of stroke that might promote the process of recovery such as selective serotonin reuptake inhibitors and constraint-induced movement therapy shows great promise. 5,6 Acupuncture which has been used for treating stroke for >1000 years might act in a similar way. Experimental studies have showed its potential beneficial effects in post stroke rehabilitation.…”

mentioning

confidence: 99%

Acupuncture Efficacy on Ischemic Stroke Recovery

Zhang

Liu

et al. 2015

Stroke

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Therefore, we designed this randomized controlled trials with a larger sample, and scales to Background and Purpose-Acupuncture is a frequently used complementary treatment for ischemic stroke in China but the evidence available from previous randomized trials is inconclusive. The objective of this study was to assess the efficacy and safety of acupuncture in a more robustly designed larger scale trial. Methods-This is a multicenter, single-blinded, randomized controlled trial. Eight hundred sixty-two hospitalized patients with limb paralysis between 3 to 10 days after ischemic stroke onset were allocated acupuncture plus standard care or standard care alone. The acupuncture was applied 5 times per week for 3 to 4 weeks. The primary outcomes were defined as follows: (1) death/disability according to Barthel index and (2) death/institutional care at 6 months. Results-There was a tendency of fewer patients being dead or dependent in acupuncture group (80/385, 20.7%) than in control group (102/396, 25.8%) at 6 months (odds ratio, 0.75; 95% confidence interval, 0.54-1.05). The benefit was noted in subgroup receiving ≥10 sessions of acupuncture (odds ratio, 0.68; 95% confidence interval, 0.47-0.98). There was no statistical difference in death or institutional care between the 2 groups (odds ratio, 1.06; 95% confidence interval, 0.63-1.79). Severe adverse events occurred in 7.6% and 8.3% of patients in the 2 groups, respectively. Conclusions-Acupuncture seemed to be safe in the subacute phase of ischemic stroke. If the potential benefits observed are confirmed in future larger study, the health gain from wider use of the treatment could be substantial. Clinical Trial Registration-URL: http://www.chictr.org/en/. Unique identifier: ChiCTR-TRC-11001353.

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Constraint-induced movement therapy for upper extremities in stroke patients

Cited by 125 publications

References 118 publications

Use-Dependent Hemispheric Balance

Use-Dependent Hemispheric Balance

Effects of Scapular Stabilization Exercise on Function of Paretic Upper Extremity of Chronic Stroke Patients

Acupuncture Efficacy on Ischemic Stroke Recovery

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