Does intensive upper limb treatment modality Hybrid Constrained Induced Movement Therapy (H-CIMT) improve grip and pinch strength or fatigability of the affected hand?

Abstract

H-CIMT showed to be effective in increasing muscle pinch strength in the AH. Effectiveness in decreasing muscle fatigue during grip and pinch tests is not yet shown although there was a tendency towards a decrease in muscle fatigue. However, the long-term effects on these aspects are also important in future research.

Measuring Motor Fatigability in the Upper Limbs in Individuals With Neurologic Disorders: A Systematic Review

“…Three nonrandomized studies were rated with the ROBINS-I. [38][39][40] The results indicated an overall serious RoB in 1 study 40 and a moderate RoB in 2 studies. 38,39 Most problems originated from the selection of the participants, handling of missing data, and the measurement of the outcomes (supplemental table S3, available online only at http://www.archives-pmr.org/).…”

“…17,26 In 14 studies, no definition for motor fatigability was provided. 7,15,[19][20][21]23,28,30,34,[36][37][38][39][40]…”

“…In total, 712 subjects were included in the studies, ranging from 6-60 subjects per study. In 11 studies, subjects with MS were included, [8][9][10][15][16][17]21,29,[31][32][33]35 6 studies included children with CP, 5,18,20,34,36,39 and 5 studies included subjects with SCI 15,28,37,38,40 (see table 1).…”

“…Twenty-three protocols used isometric muscle contractions. Of these, 14 used a maximal isometric contraction [6][7][8][9]21,25,27,[33][34][35][36][38][39][40] and 9 used submaximal isometric contractions with intensities ranging from 10%-80% of maximal contractions 5,18,[22][23][24]26,33,34,38 (see fig 2). Eight protocols used repeated contractions to investigate motor fatigability.…”

“…Twenty-five protocols used different calculations of strength as an outcome measure for fatigability. In general, 3 different methods were used: percentage of change in maximum voluntary contraction (MVC) force 6,7,16,17,21,23,24,31,33,35 ; a static fatigue index (SFI) [8][9][10]25,27,34,39 ; and a dynamic fatigue index (DFI). 8,9,25,37 The SFI is a fatigue calculation based on the AUC of a forcetime curve, divided by a HAUC, mimicking a situation where strength would have been sustained at maximum level during the trial.…”