Potential Predictors of Motor and Functional Outcomes After Distributed Constraint-Induced Therapy for Patients With Stroke

Lin, Keh‐chung; Huang, Yanhua; Hsieh, Yu‐Wei; Wu, Ching‐yi

doi:10.1177/1545968308321773

Cited by 47 publications

(43 citation statements)

References 56 publications

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“…Another study limitation includes the lack of information regarding the functional status of each patient subject. Other than FIM score, which has been shown to be an insensitive predictor [33], functional status information is not typically collected during rehabilitation sessions and, thus, reflects a limitation of our rehabilitation system. In addition, this study documented the types and number of reps performed but did not address many other issues that may affect functional improvement, such as "quality" versus "quantity" of movement, duration, types of feedback or cues given, and the cognitive demand of the task.…”

Section: Discussionmentioning

confidence: 99%

Comparison of amounts and types of practice during rehabilitation for traumatic brain injury and stroke

Kimberley¹,

Samargia²,

Moore³

et al. 2010

JRRD

119

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Abstract-Patients with acquired neurological deficits may capitalize on cortical reorganization to recover functional skills that have been lost. Research in neuroplasticity proposes that a high number of repetitions may lead to cortical reorganization. The purposes of this study were to quantify the number and type of activities performed by patients with traumatic brain injury (TBI) and stroke in physical and occupational therapy sessions to determine whether (1) the number of repetitions approaches the numbers in neuroplasticity research, (2) there were differences based on patient diagnosis, and (3) patient or therapist characteristics affected the type or amount of activities performed. Forty-eight patient and forty provider subjects participated. One hundred seven therapy sessions were observed. Data from therapy sessions were counted and categorized. Neither patient group approached the total number of repetitions neuroplasticity research suggests may be required for neuroplastic change. Repetitions per session did not differ between groups. Subjects with TBI performed more repetitions per minute in three categories (total upper-limb repetitions, gait steps, and transfers) than subjects with stroke. Therapists with <1 year or >15 years of neurological therapy experience instructed patients in fewer functional repetitions per minute than did therapists with 5 to 15 years of experience.

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Section: Discussionmentioning

confidence: 99%

Comparison of amounts and types of practice during rehabilitation for traumatic brain injury and stroke

Kimberley¹,

Samargia²,

Moore³

et al. 2010

JRRD

119

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“…11 Identifying the factors affecting successful outcomes and the patients most likely to respond to the therapy would be informative for clinical guidelines. Although the initial motor status of patients with stroke is viewed as an important factor that influences recovery, 12,13 whether this factor affects the outcomes of RT remains unknown. We therefore investigated the effects of RT on clinical outcomes in patients with chronic stroke by using higher-intensity and lower-intensity RT relative to a duration-matched control treatment (CT) and also examined whether the initial severity of motor deficits and the treatment intensities of RT interact to influence the primary outcome.…”

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confidence: 99%

Dose–Response Relationship of Robot-Assisted Stroke Motor Rehabilitation

Hsieh

Wu²,

Lin³

et al. 2012

Stroke

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Background and Purpose-The increasing availability of robot-assisted therapy (RT), which provides quantifiable, reproducible, interactive, and intensive practice, holds promise for stroke rehabilitation, but data on its dose-response relation are scanty. This study used 2 different intensities of RT to examine the treatment effects of RT and the effect on outcomes of the severity of initial motor deficits. Methods-Fifty-four patients with stroke were randomized to a 4-week intervention of higher-intensity RT, lower-intensity RT, or control treatment. The primary outcome, the Fugl-Meyer Assessment, was administered at baseline, midterm, and posttreatment. Secondary outcomes included the Medical Research Council scale, the Motor Activity Log, and the physical domains of the Stroke Impact Scale. Results-The higher-intensity RT group showed significantly greater improvements on the Fugl-Meyer Assessment than the lower-intensity RT and control treatment groups at midterm (Pϭ0.003 and Pϭ0.02) and at posttreatment (Pϭ0.04 and Pϭ0.02). Within-group gains on the secondary outcomes were significant, but the differences among the 3 groups did not reach significance. Recovery rates of the higher-intensity RT group were higher than those of the lower-intensity RT group, particularly on the Fugl-Meyer Assessment. Scatterplots with curve fitting showed that patients with moderate motor deficits gained more improvements than those with severe or mild deficits after the higherintensity RT. Conclusions-This study demonstrated the higher treatment intensity provided by RT was associated with better motor outcome for patients with stroke, which may shape further stroke rehabilitation. Clinical Trial Registration-URL: http://clinicaltrials.gov. Unique identifier: NCT00917605.

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“…Constraint-induced therapy (CIT) and its distributed form (dCIT) have been advocated for use in stroke rehabilitation to improve a multitude of functional outcomes (Boake et al, 2007;Dettmers et al, 2005;Lin, Huang, Hsieh, & Wu, 2009;Lin, Wu, Liu, Chen, & Hsu, 2009;Lin et al, 2007;Rowe, Blanton, & Wolf, 2009;Sunderland & Tuke, 2005;Wu, Chen, Chen, Lin, & Yeh, 2012;Wu, Chen, Tsai, Lin, & Chou, 2007). CIT involves constraint of the unaffected upper extremity (UE), allowing the use of only the affected arm daily for 2 wk (Sunderland & Tuke, 2005).…”

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confidence: 99%

“…CIT involves constraint of the unaffected upper extremity (UE), allowing the use of only the affected arm daily for 2 wk (Sunderland & Tuke, 2005). CIT has been modified to dCIT, a less intensive form that involves 2-3 hr of training of the affected arm combined with 6-9 hr of daily restraint of the unaffected arm for 2-4 wk (Boake et al, 2007;Dettmers et al, 2005;Lin et al, 2007;Lin, Huang, et al, 2009;Wu et al, 2007). Several randomized controlled trials have demonstrated that CIT and dCIT are effective in improving QOL for stroke patients (Lin, Chang, Wu, & Chen, 2009;Lin et al, 2007;Rowe et al, 2009;Wu et al, 2007).…”

mentioning

confidence: 99%

“…Although several studies have reported that motor ability of the distal part of the arm, time since stroke, age, and gender can predict improvement in motor performance after CIT (Lin, Huang, et al, 2009;Rijntjes et al, 2005), the potential predictors of HRQOL improvement after CIT have received scant attention. Only one previous study has examined the predictors of HRQOL as measured with the SIS after dCIT.…”

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confidence: 99%

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Determinants of Change in Stroke-Specific Quality of Life After Distributed Constraint-Induced Therapy

Huang

Lin

et al. 2013

The American Journal of Occupational Therapy

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OBJECTIVE. We identified the predictive factors of change in quality of life (QOL) after a distributed form of constraint-induced therapy (dCIT) among stroke survivors.METHOD. Seventy-four participants were treated with dCIT. We identified eight potential determinants of change: age, gender, side of lesion, time since stroke, cognitive status, motor impairment of the upper extremity, activities of daily living (ADLs), and instrumental ADLs (IADLs). The Stroke-Specific Quality of Life Scale (SS-QOL) was used to assess QOL.RESULTS. Right-sided lesion and onset >17 mo earlier determined greater improvement in the SS-QOL Energy domain. Onset >10 mo earlier, poorer IADL performance, and age >68 yr predicted improvement in the Family Role, Mobility, and Mood domains, respectively. CONCLUSION.Side of lesion, time since stroke, IADL performance, and age were the most important determinants of QOL in patients receiving stroke motor rehabilitation.

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Potential Predictors of Motor and Functional Outcomes After Distributed Constraint-Induced Therapy for Patients With Stroke

Cited by 47 publications

References 56 publications

Comparison of amounts and types of practice during rehabilitation for traumatic brain injury and stroke

Comparison of amounts and types of practice during rehabilitation for traumatic brain injury and stroke

Dose–Response Relationship of Robot-Assisted Stroke Motor Rehabilitation

Determinants of Change in Stroke-Specific Quality of Life After Distributed Constraint-Induced Therapy

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