Neurorestorative Effects of Constraint-Induced Movement Therapy after Stroke: An Integrative Review

Lucas, Marina; Ribeiro, Pedro; Cagy, Maurício; Teixeira, Silmar; Chaves, Fernanda; Carvalho, Diana M.; Peressutti, Caroline; Machado, Sérgio; Bittencourt, Juliana; Velasques, Bruna; Piedade, Roberto

doi:10.4236/nm.2013.44036

Cited by 6 publications

(5 citation statements)

References 69 publications

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“…These data determined that FL overuse enhances SVZ-derived cell migration to the peri-infarct motor cortex, survival, and differentiation in larger numbers compared with stroke alone. Behavioral overuse of an affected limb after stroke involves an increased excitability in the motor cortex adjacent to the stroke site (28). To directly test the role of cellular activity in neurogenesis after stroke, Designer Receptors Exclusively Activated by Designer Drugs (DREADD)-based chemogenetic tools were utilized.…”

Section: Resultsmentioning

confidence: 99%

Region-specific and activity-dependent regulation of SVZ neurogenesis and recovery after stroke

Liang

Zhao

Gleichman

et al. 2019

Proc. Natl. Acad. Sci. U.S.A.

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Stroke is the leading cause of adult disability. Neurogenesis after stroke is associated with repair; however, the mechanisms regulating poststroke neurogenesis and its functional effect remain unclear. Here, we investigate multiple mechanistic routes of induced neurogenesis in the poststroke brain, using both a forelimb overuse manipulation that models a clinical neurorehabilitation paradigm, as well as local manipulation of cellular activity in the peri-infarct cortex. Increased activity in the forelimb peri-infarct cortex via either modulation drives increased subventricular zone (SVZ) progenitor proliferation, migration, and neuronal maturation in peri-infarct cortex. This effect is sensitive to competition from neighboring brain regions. By using orthogonal tract tracing and rabies virus approaches in transgenic SVZ-lineage-tracing mice, SVZ-derived neurons synaptically integrate into the peri-infarct cortex; these effects are enhanced with forelimb overuse. Synaptic transmission from these newborn SVZ-derived neurons is critical for spontaneous recovery after stroke, as tetanus neurotoxin silencing specifically of the SVZ-derived neurons disrupts the formation of these synaptic connections and hinders functional recovery after stroke. SVZ-derived neurogenesis after stroke is activity-dependent, region-specific, and sensitive to modulation, and the synaptic connections formed by these newborn cells are functionally critical for poststroke recovery.

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Section: Resultsmentioning

confidence: 99%

Region-specific and activity-dependent regulation of SVZ neurogenesis and recovery after stroke

Liang

Zhao

Gleichman

et al. 2019

Proc. Natl. Acad. Sci. U.S.A.

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“…[30] Aplicaciones en enfermedad cerebrovascular El proceso de instauración de esta modalidad terapéutica estará en dependencia de la aplicabilidad y generación de resultados a las personas sometidas al proceso; en ese sentido, Liepert encontró como resultado relevante un aumento del tamaño de la zona del abductor pollicis brevis, sugiriendo por un aumento de la excitabilidad de la red neuronal en el hemisferio lesionado de las personas con ECV crónica, [31] en áreas corticales como la corteza motora primaria, la corteza dorsal pre -motora y área motora suplementaria. [32] Universidad de Manizales -Facultad de Ciencias de la Salud del ECV. Entre los efectos significativos sobre función motora aportados se encuentra un meta -análisis, cuyas mediciones de la función motora del brazo mostró resultados positivos inmediatos, posterior a la aplicación del tratamiento en las personas con ECV, un efecto moderado sobre la actividad motora del brazo inmediatamente después del tratamiento, en 3-6 meses de seguimiento y una gran heterogeneidad entre los estudios en el ámbito de la actividad motora del brazo.…”

Section: Resultados Definición Y Reseña Históricaunclassified

Terapia de restricción del lado sano como opción de manejo de personas con secuelas de enfermedad cerebrovascular.

Mora

Serna²,

Muñoz³

et al. 2017

archmed

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La terapia de restricción del lado sano se considera una de las alternativas actuales en neurorehabilitación, en esta se realiza un bloqueo del lado no afectado, propiciando así el desarrollo de habilidades en el lado hemipléjico, a partir de la práctica de actividades sucesivas y tareas adaptadas. Objetivo: los efectos a nivel de función de la mano espástica en adultos con hemiplejia a partir de un proceso de revisión de literatura contenida en diferentes bases de datos. Métodos: se realizó una búsqueda de literatura en diferentes bases de datos como Pubmed, PeDro, OtSeeker, Scient Direct, usando como término de búsqueda “stroke” and “constraint induced movement therapy; se recopiló la información que tratara acerca de la técnica y su aplicación en personas hemipléjicas adultas. Conclusiones: La literatura revisada muestra que la terapia de restricción del lado sano genera múltiples beneficios en cuanto a función del brazo y de mano específicamente, para la función motora de miembro superior (agarres, alcances) y por ende en independencia funcional. Se recomienda la aplicación de los protocolos más difundidos en población latinoamericana al igual que establecer costo efectividad y la adopción de esta estrategia en planes de intervención clínicos.

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“…Neuroimaging studies have shown that stroke patients participating in CIMT and mCIMT undergo neuroplastic changes in brain function and structure. Several cortical areas, such as the primary motor cortex, dorsal premotor cortex, and supplementary motor area, show increased electrical and metabolic neuronal activity during CIMT and mCIMT (Szaflarski, Page, Kissela, Lee, Levine, & Strakowski, 2006;Yadav, Sharma, Borah, & Kothari, 2016;Lucas et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Proprioceptive based training or modified constraint-induced movement therapy on upper extremity motor functions in chronic stroke patients: A randomized controlled study

Alaca

Öcal²

2022

NRE

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BACKGROUND: The Modified Constraint-Induced Movement Therapy (mCIMT) method is a unilateral training that respectively avoids and activates less affected and affected sides of upper extremities; however, the selected options are not typically ideal. Proprioceptive based training (PT) includes bilateral training methods and influencing proprioceptive receptors. OBJECTIVE: The primary purpose was to determine if conventional therapy and PT or conventional therapy and mCIMT therapy show similar improvement in patients with chronic stroke. The secondary purpose was to investigate the effectiveness of conventional therapy and PT or mCIMT therapy in patients with chronic stroke and to compare which of the two interventions is more effective. METHODS: Forty patients with chronic stroke were randomly allocated to only conventional therapy (PTR, n = 14), conventional therapy plus proprioception training (PTR-PT, n = 13), and mCIMT (PTR-mCIMT, n = 13) groups. Evaluations were assessed before and 6 weeks after treatment. RESULTS: Intragroup evaluations revealeda significant improvement in the all scores in the PTR-PT and PTR-mCMIT groups (p = 0.006 < 0.001). Intergroup comparisons demonstrated that the PTR-mCIMT group had a significant improvement in spasticity and motor function scores compared to the PTR (p < 0.001) and the PTR-PT groups (p = 0.006–0.015). CONCLUSIONS: PT and mCMIT applied in addition to conventional therapy in patients with chronic stroke were more effective than only conventional therapy. Additionally, mCMIT showed greater improvement in spasticity and motor function scales than PT.

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Neurorestorative Effects of Constraint-Induced Movement Therapy after Stroke: An Integrative Review

Cited by 6 publications

References 69 publications

Region-specific and activity-dependent regulation of SVZ neurogenesis and recovery after stroke

Region-specific and activity-dependent regulation of SVZ neurogenesis and recovery after stroke

Terapia de restricción del lado sano como opción de manejo de personas con secuelas de enfermedad cerebrovascular.

Proprioceptive based training or modified constraint-induced movement therapy on upper extremity motor functions in chronic stroke patients: A randomized controlled study

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