Effect of Gravity and Task Specific Training of Elbow Extensors on Upper Extremity Function after Stroke

Abstract

Background In individuals with hemiparetic stroke, reaching with the paretic arm can be impaired by abnormal muscle coactivation. Prior trails for improving upper extremity functions after stroke have underestimated the role of gravitational force in motor planning and execution. Objective The aims this trial were to study the effect of gravity as a facilitator for elbow extension and to estimate the immediate and retention effects of task specific training of elbow extensors on upper extremity function after stroke. Methods Twenty-six right handed patients with first ever stroke represented the sample of the study. The participants were randomly assigned into two equal groups. The study group received treatment through two phases. Phase one included training for the elbow extensors in an antigravity position. Phase two included a set of task specific exercise for 16 weeks. The control group received traditional passive stretch and range of motion exercises. Manual dexterity and upper limb function were assessed by Nine-Hole Peg Test and Fugl-Meyer upper extremity. Goniometry was used for measuring elbow extension and forearm supination active ranges of motion. Results Significant improvements were observed in Nine-Hole Peg Test, Fugl-Meyer upper extremity, and ranges of motion at postintervention and follow-up compared to preintervention at P≤0.05. Conclusions The results of this study provide an evidence that antigravity positions can be used as a centrally presented facilitator of elbow extension. Additionally, task specific training was effective in improving upper extremity function and elbow extension range of motion.

Therapeutic Efficacy of Transcutaneous Electrical Nerve Stimulation Acupoints on Motor and Neural Recovery of the Affected Upper Extremity in Chronic Stroke: A Sham-Controlled Randomized Clinical Trial

“…Task-specific training (TST) is a treatment strategy that adopts concepts of motor relearning approach [19] and involves practicing goal-directed, functional everyday tasks such as holding a cup in an environment like the original one [20,21]. TST promotes the recovery of paretic muscles in stroke patients [22][23][24] and can be considered more effective than traditional physical therapy approaches [25].…”

“…Quantitative electroencephalography (QEEG) is a noninvasive, affordable neurophysiological technique that measures brain activity during various stroke recovery stages [26]. It is divided into four standard frequency bands, which are delta (1-4 Hz), theta (4-8 Hz), alpha (8-12 Hz) and beta (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). QEEG can provide valuable information regarding the effectiveness of various physical therapy modalities in the management of stroke patients [3,27].…”