The Effect of Modified Constraint-Induced Movement Therapy on Spasticity and Motor Function of the Affected Arm in Patients with Chronic Stroke

Siebers, A; Öberg, Ulrika; Skargren, Elisabeth

doi:10.3138/physio.62.4.388

Cited by 47 publications

(22 citation statements)

References 39 publications

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“…The piano intervention, which yielded a mean increase of 7.4 blocks on the BBT, may compare advantageously with other therapies such as constraint-induced movement therapy where gains of 4–4.5 blocks were reported after intensive arm restriction (3 h to 90% of waking hours for 2–4 weeks) (Leung et al, 2009; Siebers et al, 2010). Since the piano intervention relies on user-friendly and commercially available equipment, it also has the potential to be self-managed and pursued beyond the usual rehabilitation time frame.…”

Section: Discussionmentioning

confidence: 99%

A Piano Training Program to Improve Manual Dexterity and Upper Extremity Function in Chronic Stroke Survivors

Villeneuve

Penhune

Lamontagne

2014

Front. Hum. Neurosci.

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Objective: Music-supported therapy was shown to induce improvements in motor skills in stroke survivors. Whether all stroke individuals respond similarly to the intervention and whether gains can be maintained over time remain unknown. We estimated the immediate and retention effects of a piano training program on upper extremity function in persons with chronic stroke.Methods: Thirteen stroke participants engaged in a 3-week piano training comprising supervised sessions (9 × 60 min) and home practice. Fine and gross manual dexterity, movement coordination, and functional use of the upper extremity were assessed at baseline, pre-intervention, post-intervention, and at a 3-week follow-up.Results: Significant improvements were observed for all outcomes at post-intervention and follow-up compared to pre-intervention scores. Larger magnitudes of change in manual dexterity and functional use of the upper extremity were associated with higher initial levels of motor recovery.Conclusion: Piano training can result in sustainable improvements in upper extremity function in chronic stroke survivors. Individuals with a higher initial level of motor recovery at baseline appear to benefit the most from this intervention.

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Section: Discussionmentioning

confidence: 99%

A Piano Training Program to Improve Manual Dexterity and Upper Extremity Function in Chronic Stroke Survivors

Villeneuve

Penhune

Lamontagne

2014

Front. Hum. Neurosci.

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“…Over the last decade, intensive interventions based on motor skill learning principles have demonstrated efficacy, inducing motor changes and improving activities of daily life in children with CP. [10][11][12][13][14][15] The JTTHF assesses a battery of seven items of unimanual hand functions simulating activities of daily living. These skills in children with CP, both in research and clinical practice, are frequently assessed using the Box and Block Test (BBT) 8 and the Jebsen-Taylor Test of Hand Function (JTTHF).…”

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confidence: 99%

Reliability and responsiveness of the Jebsen‐Taylor Test of Hand Function and the Box and Block Test for children with cerebral palsy

Araneda

Ebner‐Karestinos

Paradis

et al. 2019

Develop Med Child Neuro

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METHOD In this retrospective study, the reliability analyses were conducted with paired t-tests considering a short (mean 14d) and a long (mean 120d) time in between two assessment periods. In addition, an intraclass correlation coefficient (ICC) was used to assess the level of congruency. The responsiveness to therapy was conducted with a paired t-test in the whole sample regarding the age, the manual ability level as classified with the Manual Ability Classification System (MACS), and the topography. RESULTSOur main results confirmed the tests' reliability in a short time period for the JTTHF in both hands and for the BBT on the less affected hand. These results were consistent with the ICC. The responsiveness was confirmed, except on the less affected hand for the JTTHF, with similar results for age, MACS, and topography approach.INTERPRETATION This study supports the use of the JTTHF and the BBT to examine changes after short-term interventions for children with CP. These results should be interpreted with association to normative values or with a control group when used over long assessment periods.

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“…Evidence supports the validity, test-retest reliability and interrater reliability [55] of the BBT [54]. Previous studies suggest that a change score of 4 blocks per minute over a 2 week treatment timeframe represents clinically significant change [55]. It is unknown whether repeating the BBT within a one hour timeframe (for RCT1) will have a practice effect.…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of functional hand splinting and the cognitive orientation to occupational performance (CO-OP) approach in children with cerebral palsy and brain injury: two randomised controlled trial protocols

2014

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BackgroundCerebral palsy (CP) and brain injury (BI) are common conditions that have devastating effects on a child’s ability to use their hands. Hand splinting and task-specific training are two interventions that are often used to address deficits in upper limb skills, both in isolation or concurrently. The aim of this paper is to describe the method to be used to conduct two randomised controlled trials (RCT) investigating (a) the immediate effect of functional hand splints, and (b) the effect of functional hand splints used concurrently with task-specific training compared to functional hand splints alone, and to task-specific training alone in children with CP and BI. The Cognitive Orientation to Occupational Performance (CO-OP) approach will be the task-specific training approach used.Methods/DesignTwo concurrent trials; a two group, parallel design, RCT with a sample size of 30 participants (15 per group); and a three group, parallel design, assessor blinded, RCT with a sample size of 45 participants (15 per group). Inclusion criteria: age 4-15 years; diagnosis of CP or BI; Manual Abilities Classification System (MACS) level I – IV; hand function goals; impaired hand function; the cognitive, language and behavioural ability to participate in CO-OP. Participants will be randomly allocated to one of 3 groups; (1) functional hand splint only (n=15); (2) functional hand splint combined with task-specific training (n=15); (3) task-specific training only (n=15). Allocation concealment will be achieved using sequentially numbered, sealed opaque envelopes opened by an off-site officer after baseline measures. Treatment will be provided for a period of 2 weeks, with outcome measures taken at baseline, 1 hour after randomisation, 2 weeks and 10 weeks. The functional hand splint will be a wrist cock-up splint (+/- thumb support or supination strap). Task-specific training will involve 10 sessions of CO-OP provided in a group of 2-4 children. Primary outcome measures will be the Canadian Occupational Performance Measure (COPM) and the Goal Attainment Scale (GAS). Analysis will be conducted on an intention-to-treat basis.DiscussionThis paper outlines the protocol for two randomised controlled trials investigating functional hand splints and CO-OP for children with CP and BI.

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The Effect of Modified Constraint-Induced Movement Therapy on Spasticity and Motor Function of the Affected Arm in Patients with Chronic Stroke

Abstract: Our study suggests that modified CIMT in an outpatient clinic may reduce spasticity and increase functional use of the affected arm in spastic chronic hemiplegia, with improvements persisting at 6 months.

Cited by 47 publications

References 39 publications

A Piano Training Program to Improve Manual Dexterity and Upper Extremity Function in Chronic Stroke Survivors

A Piano Training Program to Improve Manual Dexterity and Upper Extremity Function in Chronic Stroke Survivors

Reliability and responsiveness of the Jebsen‐Taylor Test of Hand Function and the Box and Block Test for children with cerebral palsy

Effectiveness of functional hand splinting and the cognitive orientation to occupational performance (CO-OP) approach in children with cerebral palsy and brain injury: two randomised controlled trial protocols

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