Recovering functional independence after a stroke through Modified Constraint-Induced Therapy

Article type: Research Article

Authors: Doussoulin, A.^{a; *} | Arancibia, M.^a | Saiz, J.^b | Silva, A.^c | Luengo, M.^d | Salazar, A.P.^e

Affiliations: [a] Department of Pediatrics and Child Surgery, Universidad de La Frontera, Temuco, Chile | [b] Department of Psychology, Universidad de La Frontera, Temuco, Chile | [c] Graduate Program of Health Sciences, Federal University of Porto Alegre, Brazil | [d] Domiciliary Hospitalization Program, Hospital Villarrica, Chile | [e] Rehabilitation Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Brazil

Correspondence: [*] Address for correspondence: Arlette Doussoulin, Hoschtetter 405, Temuco, Chile. Tel.: +56 45 2732411; Fax: +56 45 2744308; E-mail: arlette.doussoulin@ufrontera.cl.

Abstract: BACKGROUND: Population ageing and changes in the epidemiological profile of neurological pathologies has resulted in an increase in patients with disabilities. Rehabilitation strategies such as Modified Constraint-Induced Movement Therapy (CIMTm) play a key role in treating patients with neurologic deficiencies and motor impairments. This intervention is intended to mitigate disability, promote maximum functional independence, and optimize social and economic participation of patients with upper extremity weakness. Our goal was to assess the recovery of functional independence in patients after a stroke using to CIMTm. PATIENTS AND METHOD: Thirty-six subjects who had suffered stroke took part in a randomised clinical trial. The treatment was applied through either collective or individual modalities for three hours per day for a period of ten days. Participant’s functional independence was assessed using the Functional Independence Measure (FIM) scale at the before and after of the intervention. RESULTS: An analysis of covariance carried out on the pre-test assessments indicates that the dependent variable presents significant differences (F1.31 = 42.78, p < 0.001, η2p = 0.72) in favour of the collective intervention modality. CONCLUSION: Both modalities of CIMTm intervention promote functional independence. However, the greatest improvements were observed in participants in the collective modality. Improvements in functional independence pursue a reduction in learned non-use behaviours through greater use of the paretic upper extremity in everyday activities.

Keywords: Disability, functionality, functional independence, rehabilitation, stroke, upper extremity

DOI: 10.3233/NRE-161409

Journal: NeuroRehabilitation, vol. 40, no. 2, pp. 243-249, 2017