A 6-month follow-up after constraint-induced movement therapy with and without transfer package for patients with hemiparesis after stroke: a pilot quasi-randomized controlled trial

Takebayashi, Takashi; Koyama, Tetsuo; Amano, Satoru; Hanada, Keisuke; Tabusadani, Mitsuru; Hosomi, Masashi; Marumoto, Kohei; Takahashi, Kayoko; Domen, Kazuhisa

doi:10.1177/0269215512460779

Cited by 53 publications

(54 citation statements)

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“…13,62 Despite the varied intervention options, a significant percentage of individuals are unable to maintain and generalize the gains achieved in therapy to the natural environment after therapy ends. 63–65 Although task-oriented training approaches highlight the importance of repetition and task specificity, they sometimes downplay the achievement of skilled movement in the service of functional tasks. Maladaptive or “bad use” may occur when less optimal, unskilled, solutions—ones that rely on compensatory strategies—are used.…”

Section: Infusing Contemporary Motor Learning Into Neurorehabilitatiomentioning

confidence: 99%

Infusing Motor Learning Research Into Neurorehabilitation Practice

Winstein

Lewthwaite

Blanton

et al. 2014

Journal of Neurologic Physical Therapy

138

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This special interest article provides a historical framework with a contemporary case example that traces the infusion of the science of motor learning into neurorehabilitation practice. The revolution in neuroscience provided the first evidence for learning-dependent neuroplasticity and presaged the role of motor learning as critical for restorative therapies after stroke. The scientific underpinnings of motor learning have continued to evolve from a dominance of cognitive or information processing perspectives to a blend with neural science and contemporary social-cognitive psychological science. Furthermore, advances in the science of behavior change have contributed insights into influences on sustainable and generalizable gains in motor skills and associated behaviors, including physical activity and other recovery-promoting habits. For neurorehabilitation, these insights have tremendous relevance for the therapist–patient interactions and relationships. We describe a principle-based intervention for neurorehabilitation termed the Accelerated Skill Acquisition Program that we developed. This approach emphasizes integration from a broad set of scientific lines of inquiry including the contemporary fields of motor learning, neuroscience, and the psychological science of behavior change. Three overlapping essential elements—skill acquisition, impairment mitigation, and motivational enhancements—are integrated.

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Section: Infusing Contemporary Motor Learning Into Neurorehabilitatiomentioning

confidence: 99%

Infusing Motor Learning Research Into Neurorehabilitation Practice

Winstein

Lewthwaite

Blanton

et al. 2014

Journal of Neurologic Physical Therapy

138

View full text Add to dashboard Cite

show abstract

“…This learned non-use phenomenon is responsible for increased weaknesses, decreased abilities of the paretic upper limb in performing unimanual and bimanual activities, and restricted social participation5 - 9. Therefore, the treatment of such residual deficits is critically important for the stroke population and Constraint-Induced Movement Therapy (CIMT) has emerged as a promising intervention to improve upper limb function after stroke10 , 11. …”

Section: Introductionmentioning

confidence: 99%

Influences of hand dominance on the maintenance of benefits after home-based modified constraint-induced movement therapy in individuals with stroke

Lima¹,

Nascimento²,

Michaelsen³

et al. 2014

Braz. J. Phys. Ther.

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Objective:To investigate the influence of hand dominance on the maintenance of gains after home-based modified constraint-induced movement therapy (mCIMT). Method:Aprevious randomized controlled trial was conducted to examine the addition of trunk restraint to the mCIMT. Twenty-two chronic stroke survivors with mild to moderate motor impairments received individual home-based mCIMT with or without trunk restraints, five times per week, three hours daily over two weeks. In this study, the participants were separated into dominant group, which had their paretic upper limb as dominant before the stroke (n=8), and non-dominant group (n=14) for analyses. The ability to perform unimanual tasks was measured by the Wolf Motor Function Test (WMFT) and the Motor Activity Log (MAL), whereas the capacity to perform bimanual tasks was measured using the Bilateral Activity Assessment Scale (BAAS). Results:Analysis revealed significant positive effects on the MAL amount of use and quality of the movement scales, as well as on the BAAS scores after intervention, with no differences between groups. Both groups maintained the bimanual improvements during follow-ups (BAAS-seconds 0.1, 95% CI -10.0 to 10.0), however only the dominant group maintained the unilateral improvements (MAL-amount of use: 1.5, 95% CI 0.7 to 2.3; MAL-quality: 1.3, 95% CI 0.5 to 2.1). Conclusions:Upper limb dominance did not interfere with the acquisition of upper limb skills after mCIMT. However, the participants whose paretic upper limb was dominant demonstrated better abilities to maintain the unilateral gains. The bilateral improvements were maintained, regardless of upper limb dominance.

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“…Some researchers consider the transfer package the most important component of CIMT. In fact, research has shown that usage of the affected arm in daily life is significantly different between patients treated with and without the transfer package component (16, 17). However, many therapists question whether CIMT could benefit their patients because of the shortage of sites possessing the clinical resources to provide the intervention for the long duration required for effectiveness (18).…”

Section: Introductionmentioning

confidence: 99%

Assessment of the Efficacy of ReoGo-J Robotic Training Against Other Rehabilitation Therapies for Upper-Limb Hemiplegia After Stroke: Protocol for a Randomized Controlled Trial

et al. 2018

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Background: Stroke patients experience chronic hemiparesis in their upper extremities leaving negative effects on quality of life. Robotic therapy is one method to recover arm function, but its research is still in its infancy. Research questions of this study is to investigate how to maximize the benefit of robotic therapy using ReoGo-J for arm hemiplegia in chronic stroke patients.Methods: Design of this study is a multi-center parallel group trial following the prospective, randomized, open-label, blinded endpoint (PROBE) study model. Participants and setting will be 120 chronic stroke patients (over 6 months post-stroke) will be randomly allocated to three different rehabilitation protocols. In this study, the control group will receive 20 min of standard rehabilitation (conventional occupational therapy) and 40 min of self-training (i.e., sanding, placing and stretching). The robotic therapy group will receive 20 min of standard rehabilitation and 40 min of robotic therapy using ReoGo®-J device. The combined therapy group will receive 40 min of robotic therapy and 20 min of constraint-induced movement therapy (protocol to improve upper-limb use in ADL suggests). This study employs the Fugl-Meyer Assessment upper-limb score (primary outcome), other arm function measures and the Stroke Impact Scale score will be measured at baseline, 5 and 10 weeks of the treatment phase. In analysis of this study, we use the mixed effects model for repeated measures to compare changes in outcomes between groups at 5 and 10 Weeks. The registration number of this study is UMIN000022509.Conclusions: This study is a feasible, multi-site randomized controlled trial to examine our hypothesis that combined training protocol could maximize the benefit of robotic therapy and best effective therapeutic strategy for patients with upper-limb hemiparesis.

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A 6-month follow-up after constraint-induced movement therapy with and without transfer package for patients with hemiparesis after stroke: a pilot quasi-randomized controlled trial

Abstract: Our results confirmed the long-term effects of the transfer package in constraint-induced movement therapy.

Cited by 53 publications

References 13 publications

Infusing Motor Learning Research Into Neurorehabilitation Practice

Infusing Motor Learning Research Into Neurorehabilitation Practice

Influences of hand dominance on the maintenance of benefits after home-based modified constraint-induced movement therapy in individuals with stroke

Assessment of the Efficacy of ReoGo-J Robotic Training Against Other Rehabilitation Therapies for Upper-Limb Hemiplegia After Stroke: Protocol for a Randomized Controlled Trial

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