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Effectiveness of Modified Constraint Induced Movement Therapy and bilateral arm training on Upper Extremity Function after Chronic Stroke: A Comparative Study

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Open Journal of Therapy and Rehabilitation 2016年第1期4卷 1-9页

作者： Damayanti Sethy Pankaj Bajpai Eva Snehlata Kujur Kshanaprava Mohakud Surjeet Sahoo Department of Occupational Therapy NIOH Kolkata West Bengal India SVNIRTAR Odisha India Siksha 'O' Anusandhan University Odisha India

Statement of the Problem: Upper limb hemiparesis is a common impairment underlying disability after Stroke. Transfer of treatment to daily functioning remains a question for traditional approaches used in treatment of upper extremity hemiparesis. Approaches based on Motor Learning principles may facilitate the transfer of treatment to activities of daily living. Methodology: Forty one subjects with chronic stroke, attending department of occupational therapy, National Institute for the Orthopaedically Handicapped, Kolkata, West Bengal, India participated in a single blinded randomized pre-test and post-test control group training study. Subjects were randomized over three intervention groups receiving modified Constraint Induced Movement Therapy (n = 13), bilateral arm training (n = 14), and an equally intensive conventional treatment program (n = 14). Subjects in the bilateral arm training group participated in bilateral symmetrical activities, where as subjects in constraint induced movement therapy group performed functional activities with the affected arm only and conventional group received conventional Occupational Therapy. Each group received intensive training for 1 hour/day, 5 days/week, for 8 weeks. Pre-treatment and post-treatment measures included the Fugl-Meyer measurement of physical performance (FMA- upper extremity section), action research arm test, motor activity log. Assessments were administered by a rater blinded to group assignment. Result: Both m-CIMT (p = 0.01) and bilateral arm training (p = 0.01) group showed statistically significant improvement in upper extremity functioning on Action Research arm Test score in comparison to the conventional therapy group (p = 0.33). The bilateral arm training group had significantly greater improvement in upper arm function (Proximal Fugl-Meyer Assessment score, p = 0.001);while the constraint induced movement therapy group had greater improvement of hand functions (Distal Fugl-Meyer Assessment score, p

关键词： Stroke Rehabilitation Upper Extremity bilateral arm training Constraint Induced Movement Therapy

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Cortical activity in patients with high-functioning ischemic stroke during the Purdue Pegboard Test:insights into bimanual coordinated fine motor skills with functional near-infrared spectroscopy

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Neural Regeneration Research 2024年第5期19卷 1098-1104页

作者： Siyun Chen Mengchai Mao Guangyue Zhu Yufeng Chen Yuqi Qiu Bin Ye Dongsheng Xu The Second Rehabilitation Hospital of Shanghai ShanghaiChina College of Rehabilitation Science Shanghai University of Traditional Chinese MedicineShanghaiChina Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation Ministry of EducationShanghaiChina School of Statistics East China Normal UniversityShanghaiChina The Third Rehabilitation Hospital of Shanghai ShanghaiChina Tongji University ShanghaiChina Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine ShanghaiChina

After stroke,even high-functioning individuals may experience compromised bimanual coordination and fine motor dexterity,leading to reduced functional *** arm training has been proposed as a promising intervention to address these ***,the neural basis of the impairment of functional fine motor skills and their relationship to bimanual coordination performance in stroke patients remains unclear,limiting the development of more targeted *** address this gap,our study employed functional near-infrared spectroscopy to investigate cortical responses in patients after stroke as they perform functional tasks that engage fine motor control and ***-four high-functioning patients with ischemic stroke(7 women,17 men;mean age 64.75±10.84 years)participated in this cross-sectional observational study and completed four subtasks from the Purdue Pegboard Test,which measures unimanual and bimanual finger and hand *** found significant bilateral activation of the sensorimotor cortices during all Purdue Pegboard Test subtasks,with bimanual tasks inducing higher cortical activation than the assembly ***,patients with better bimanual coordination exhibited lower cortical activation during the other three Purdue Pegboard Test ***,the observed neural response patterns varied depending on the specific *** the unaffected hand task,the differences were primarily observed in the ipsilesional *** contrast,the bilateral sensorimotor cortices and the contralesional hemisphere played a more prominent role in the bimanual task and assembly task,*** significant correlations were found between cortical activation and unimanual tasks,no significant correlations were observed with bimanual *** study provides insights into the neural basis of bimanual coordination and fine motor skills in high-functioning patients after stroke,highlighting task-dependent neural resp

关键词： bilateral arm training bimanual coordination cortical activity fine motor dexterity functional near-infrared spectroscopy(fNIRS) high-functioning Purdue Pegboard Test stroke

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