EFFECT OF ENVIRONMENT AND MODIFICATION OF OBJECTS OF DAILY USE ON HAND RECOVERY IN STROKE PATIENTS
Background: Stroke is of growing concern to health care providers worldwide especially developing countries due to the numerous predominant risk factors. Stroke patients often have compromised hand dexterity of at least one side and the hand is an integral component to accomplishing routine activities. Exercises provided to stroke patients usually are not specific to improving hand dexterity and enhancing ADL execution. Various measures like the ARAT scale and MAL can be used to assess hand function post stroke.
Objective: The objective of this study is to check the efficacy of modifications in the objects of daily use, how it enhances upper limb recovery in stroke patients.
Study design: Pre test post test control design.
Method: A total of 16 stroke patients who met the inclusion and exclusion criteria were considered for the study and allocated into groups. Group A = EX and MOT (n=8) and Group B = EX (n=8). Treatment was administered over a period of 3 weeks. Pre test and post test ARAT and MAL scores were recorded.
Results: Both the groups showed improvement in hand function but there was no statistically significant difference between the groups on analysis.
Conclusion: General rehabilitation and training with modified objects of daily used were both beneficial to the patients. Modifications to the objects of daily use however improved the individual’s ability to perform the activity more than general exercises did.
2. Jayaraj Durai Pandian and Paulin Sudhan, Paulin Sudhan; Stroke epidemiology and Stroke Care Services in India, Journal of Stroke 2013.
3. Marc Chase, Hand and Finger Exercises for Patients in Stroke Rehabilitation, August 2013. http://www.livestrong.com/article/31424
4. Nathan K. LeBrasseur, Jonathan F. Bean, Edward M Phillips, Walter R. Frontera, High intensity resistance training improves muscle strength, selfreported function and disability in long term stroke survivors, American Heart Association, April 2004;35:1404-1409
5. Marian Mullaney, Physiotherapy – Stroke care and prevention, MISCP, http://www.stroke.ie/media/pub/strokeie/marianmullaney.pdf
6. Louise Ada, Simone Dorsche and Colleen G Canning, Strengthening interventions increase strength and improve activity after stroke: a systematic review, Australian Journal of Physiotherapy 52: 241–248
7. Cormwell DA, Lawton MP, Paulos RG et al, Self Maintaining and Instrumental Activities of Daily Living, 1986; 9(3):179-186.
8. O’ Sullivan, Schmitz TJ (2000) Physical Rehabilitation: Assessment and Treatment Philadelphia: FA Davis Company, 4th edition.
9. Lisa K.Kenyon, Mary T.Blackinton, Applying Motor-Control Theory to Physical Therapy Practice. Physiother Can. 2011 Summer; 63(3):345-354.
10. Steven L.Wolf, Carolee J.Winstein, Phillip Miller et al, Effect of constraint induced movement therapy on upper extremity function 3 to 9 months after stroke. Journal of American Medical Association, November 2006; 296(17) 11. Grey Bruce District Stroke Centre, Modifying the Home After Stroke. London, July 2005.
12. Lynn Legg, Avril Drummond, Jo Leonardi Bee et al 2009, Occupational Therapy for patients with problems in personal activities of daily living after stroke: Systematic review of randomized trials”. British Medical Journal, 2009; 335(7626):922.
13. Mark L.Latash, Mindy F.Levin, John P.Scholz and Gregor Schoner, Motor Control Theories and Their Applications. Medicina (Kaunas). 2010; 46(6):382-392.
14. Rani Haley Lindberg, Stroke Rehabilitation. UAMS Department of Physical medicine and rehabilitation. Stroke 1999; 10(4):887-906.
15. Fiona C Taylor, Suresh Kumar K, Stroke in India Factsheet, 2012 South Asia Network for Chronic Disease, Public Health Foundation of India, IIPH Hyderabad
16. Nadir E. Barucha, Thomas Karuvilla, Epidemiology of stroke in India, Neurol J Southeast Asia 1998; 3: 5-8
17. Kiran Prakash P, Pilladi R.S. Thulasi et al, Effect of Modified Constraint Induced Therapy on Upper limb Functional Recovery in Young Stroke Subjects. Int J Physiother. October 2014; 1(4):220-226
18. Marluce Lopes Basilio, Faria-Fortini, Janaine Cunha, Aline A. Scianni, Christina D, Luci Fuscaldi, Handgrip strength deficits best explain limitations
in performing bimanual activities after stroke, 2016, Journal of Physical Therapy Science, 28: 1161–1165
19. Ching Lin Hsieh, I Ping Hsueh, Fu Mei Chiang and Po Hsin Lin, Inter-rater reliability and validity of the Action Research Arm Test (ARAT) in stroke patients. Age and Ageing 1998; School of Occupational Therapy, College of Medicine, National Taiwan University, Republic of China.
20. Uswatte G, Taub E, Morris D, Light K., Thompson P.A., The Motor Activity Log-28 Assessing daily use of the hemiparetic arm after stroke, Neurology, 2006;67;1189-1194
21. Shyamal Kumar Das, Tapas Kumar Banerjee, Stroke – Indian scenario, Bangur Institute of Neurosciences and Psychiatry, 2008;118:2719-2724
22. Hiraoka, K. Rehabilitation effort to improve upper extremity function in post-stroke patients: A meta-analysis. Journal of Physical Therapy Science. 2001; 13(1):5-9.
23. Yen J.G., Wang R.Y, Effectiveness of modified constraint induced movement therapy on upper limb function in stroke subjects, Acta neurol Taiwan, March 2005; 14(1):16-20.
24. El-Helow M.R., Zamzam M.L et al, Eur J Phys Rehabil Med. Efficacy of modified constraint induced movement therapy in acute stroke. July 17 2014.
25. McIntyre A., Viana R., Janzen S. Systematic review and Meta-analysis of constraint induced movement therapy in hemiparetic upper extremity more than six months post stroke. Dec 2012; 19(6):499-513.
26. Priyanka Singh and Bijayeta Pradhan to assess the effectiveness of modified constraint induced movement therapy in stroke subjects: A randomized controlled
trial. June 2013; 16(2):180-184.
27. Jennifer Ma Wai, Grace Fung Chi Yuen, Teresa Kim Kam Yu, et al, A study of constraint induced movement therapy in subacute stroke patients, Hong Kong, April 15 2007.
28. Taub E, Uswatte G, Mark VW, Morris D. The learned nonuse phenomenon: implications for rehabilitation. Eura Medicophys 2006; 42:241-255.
29. Stephen J. Page, Peter Levine, Sue Ann Sisto et al, Mental Practice combined with Physical practice for upper limb motot deficit in subacute stroke. Phys ther 2001; 81:1455-1462.
30. Yue X. Shi, Jin H.Tian, Ke H. Yang, Yue Zhao, Modified constraint-induced movement therapy versus traditional rehabilitation in patients with upper extremity dysfunction after stroke- a systematic review and meta-analysis. Arch Phys Med Rehabil 2011; 92:972-82.
31. Chong Tae Kim, Department of physical medicine and rehabilitation, University of Pennsylvania, USA; explained on Stroke Rehabilitation. http://cdn.intechopen.com/pdfswm/37902.
32. Unsworth C.A. Cognitive and Perceptual Dysfunction. In S.B. O'Sullivan & T.J. chmitz (Eds.), Physical Rehabilitation, 5th ed. Philadelphia 2007; 1180-1181.