The Effects of Constraint-Induced Movement Therapy on Improvement of Hand Function in Hemiplegic Side

Constraint-Induced Movement Therapy가 편마비측 손기능 증진에 미치는 영향

  • Ryu, In-Tae (Department of Physical Therapy, Daejun Eulji University Hospital) ;
  • Hwang, Byong-Yong (Department of Physical Therapy, College of Health Welfare, Yong In University) ;
  • Kim, Ji-Hye (Department of Physical Therapy, Greenphil hospital) ;
  • Chung, Sang-Mi (Department of Occupational Therapy, Shinsung College)
  • 유인태 (대전을지대학병원 재활의학과) ;
  • 황병용 (용인대학교 보건복지대학 물리치료학과) ;
  • 김지혜 (그린필병원 물리치료실) ;
  • 정상미 (신성대학 작업치료과)
  • Received : 2009.02.05
  • Accepted : 2009.04.23
  • Published : 2009.06.25

Abstract

Purpose: This study examined the effect of constraint-induced movement therapy (CIMT) on improving the hand function in hemiplegic side. Methods: Ten subjects without a control group were given CIMT to the hemiplegic side for 3 weeks. The effects of their hand function and sensibility were examined using a MAL and two point discrimination test. Repeated ANOVA was carried out for an analysis of the effects of the application of CIMT before and after treatment. Results: The participants showed significant improvement in their functional aspect with CIMT while there were no significant changes in the time domain variables. There was significant improvement in the quantitative and qualitative aspect of MAL, as well as significant improvement in the two-point discrimination function in all fingers. Conclusion: CIMT can enhance the motor function and sensory function of the hand in hemiplegic patients.

Keywords

References

  1. Chung MJ. The degree of Activities of Daily Living(ADL) and the Quality of Life(QL) of the CVA Patients. Kyunghee University. Dissertation of Master's Degree. 2000.
  2. Granger CV, Albrecht GL, Hamilton BB. Outcome of comprehensive medical rehabilitation: measurement by PULSES profile and the Barthel Index. Arch Phys Med Rehabil. 1979;60(4):145-54.
  3. Wilkison PR, Wolfe CD, Warburton FG et al. A long-term follow-up of stroke patients. Stroke. 1997;28(3):507-12. https://doi.org/10.1161/01.STR.28.3.507
  4. Mauguiere F, Desmedt JE, Courjon J. Astereognosis and dissociated loss frontal or parietal components of somatosensory evoked potentials in hemiparetic lesions. Brain. 1983;106:271-311. https://doi.org/10.1093/brain/106.2.271
  5. Lee TY, Oh JK, Lee KS et al. The effects of the involved upper extremity's function on the dexterity of uninvolved hand in stroke patients. J Kor Soc Occup Ther. 1999;7(1):55-7.
  6. Trombly CA. Occupational therapy for physical dysfunction. 3rd ed. Baltimore, Williams & Willkins, 1989:161-82.
  7. Jeannerrod M. The neural and behavioral organization of goal-directed movements. Oxford, Clarendon, 1988:171-208.
  8. Kusoffsky A, Wadell I, Nilsson BY. The relationship between sensory impairment and motor recovery in patients with hemiplegia. Scand J Rehabil Med. 1982;14(1):27-32.
  9. Loo Ck, Hall LA, Mccloskey DI et al. Proprioceptive contributions to tactile identification of figure; Dependence on figure size. Behav Brain Res. 1983;7(3):383-6. https://doi.org/10.1016/0166-4328(83)90029-3
  10. McClatchie G. Survey of the rehabilitation outcome of strokes. Med J Aust. 1980;1(13):649-51.
  11. Cho YH, Hwang YT, Lee MY et al. The Effect on Grip Strength in Change of Wrist Position of Normal Adults. J Kor Soc Phys Ther. 2007;19(2):33-9 https://doi.org/10.1589/jpts.19.33
  12. Basmajian JV. The winter of our discontent: breaking intolerable time locks for stroke survivors. Arch Phys Med Rehabil. 1989;70(2):92-4.
  13. Van der Lee, Johanna H, Wagenar RC et al. Force use of the upper extremity in chronic stroke patients: Result from single-blind randomized clinical trial. Stroke. 1999;30(11):2369-375. https://doi.org/10.1161/01.STR.30.11.2369
  14. Taub E, Uswatte G, Pidikiti R. Constraint-induced movement therapy: A new family of techniques with broad application to physical rehabilitation - A clinical review. J Rehabil Res Dev. 1999;36(3):237-51.
  15. Davies PM. Steps to follows: A guide to the treatment of adult hemiplegia. Berlin, Springer-Verlag, 1985.
  16. Carmick J. Clinical use of neuromuscular electrical stimulation for children with cerebral palsy, Part 2: Upper extremity. Phys Ther. 1993;73(8):514-22.
  17. Powell J, Pandyan D, Granat M et al. Electrical stimulation of wrist extensors in poststroke hemiplegia. Stroke. 1999;30(7):1384-9. https://doi.org/10.1161/01.STR.30.7.1384
  18. Duncan PW. Synthesis of intervention trials to improve motor recovery following stroke. Stroke Rehabil. 1997;3(4):1-20.
  19. Katrak P, Bowring G, Conroy P et al. Predicting upper limb recovery after stroke: the place of early shoulder and hand movement. Arch Phys Med Rehabil. 1998;79(7):758-61. https://doi.org/10.1016/S0003-9993(98)90352-5
  20. Boissy P, Bourbonnais D, Carlotti MM et al. Maximal grip force in chronic stroke subjects and its relationship to global upper extremity function. Clin Rehabil. 1999;13(4):354-62. https://doi.org/10.1191/026921599676433080
  21. Folsten MF, Mchugh PR. Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-98. https://doi.org/10.1016/0022-3956(75)90026-6
  22. Kwon YC, Park JH. Korean Version of Mini-Mental State Examination(MMSE-K) Part I: Development of the Test for the Elderly. J Korean Nouropsychiatr Assoc. 1989;28:508-13.
  23. Page SJ, Levine P, Sisto S et al. Stroke patients' and therapists' opinions of constraint-inducedmovement therapy. Clin Rehabil. 2002;16(1):55-60. https://doi.org/10.1191/0269215502cr473oa
  24. Chai KJ, Lee HS. Assessment of upper extremity function in normal Korean adults by Manual Function Test. J Kor Soc Occup Ther. 1997;5:52-7.
  25. Liepert J, Miltner W, Bauder H et al. Motor cortex plasticity during constraint-induced movement therapy in stroke patients. Neuroscience Letter. 1998;250(1):5-8. https://doi.org/10.1016/S0304-3940(98)00386-3
  26. Koop A. scientific evaluation of health effects of two plasticizers used in medical devices and toys: A report from the American Council on Science and Health, Med Gen Med. 1999;22:E14
  27. Taub E, Wolf SL. Constraint-induced movement techniques to facilitate upper extremity use in stroke patients. Stroke Rehabil. 1997;3(4):38-61.
  28. Miltner W, Bauder H, Sommer M et al. Effects of constraintinduced movement therapy on patients with chronic motor deficits after stroke: a replication. Stroke. 1999;30(3):586-92. https://doi.org/10.1161/01.STR.30.3.586
  29. Blanton S, Wolf SL. An application of upper-extremity constraint-induced movement therapy in a patient with subacute stroke. Phys Ther. 1999;79(9):847-53.
  30. Liepert J, Bauder H, Miltner W et al. Treatment-induced cortical reorganization after stroke in humans. Stroke. 2000;31(6):1210-6. https://doi.org/10.1161/01.STR.31.6.1210
  31. Kunkel A, Kopp B, Mller G et al. Constraint-induced movement therapy for motor recovery in chronic stroke patients. Arch Phys Med Rehabil. 1999;80(6):624-8. https://doi.org/10.1016/S0003-9993(99)90163-6
  32. Trombly CA, Scott Ad. Evaluation and treatment of hand function. Baltimore, Williams & Wilkins Co, 1997:235-42.
  33. Kim HW, Ko YJ, Kang SY et al. The relationship of MMSE to functional improvement in brain injured patients. J Korean Acad Rehabil Med. 1998;22(6):1179-84.
  34. Mackinnon SE. Comparative analysis of nerve injury of the face and hand. Oral Maxillofac Surg Clin North Am. 1992;4:483.
  35. Henry JB, Mohr JP, Bennenett MS et al. Stroke. New York, Churchill Livingstone, 1986:3-55.
  36. Mayo NE. The effect of physical therapy for children with motor delay and cerebral palsy. Amer Phys Med Rehabil. 1991;70(5):258-67. https://doi.org/10.1097/00002060-199110000-00006
  37. Degagi GA, Royeen CB. Current practice among neurodevelopmental treatment association members. Amer J Occup Ther. 1994;48(9):803-9. https://doi.org/10.5014/ajot.48.9.803
  38. Kim CH. The application of constraint-induced movement therapy (CIMT) on hemiplegia. Inje University. Dissertation of Master''s Degree. 2002.