Efectos de un programa autónomo de locomoción refleja adaptado a la recuperación de la mano del paciente neurológico crónico adulto. Estudio piloto pretest-postest

Abstract

BackgroundThe recovery of hand function is one of the most complex aspects for patients who have suffered the sequelae of neurological damage. ObjectiveTo evaluate the short-term effects on the affected upper limb of the autonomous performance of a reflex locomotion exercise adapted to sitting in chronic neurological patients. MethodPretest–postest design. Thirteen patients (8 women) participated with a mean age of 47.61 (SD 16.03). Possibility of clamping and minimum shoulder abduction of 30°. Three sessions were held in 2consecutive weeks, training the patient to perform the exercise at home without assistance. The effect of the therapy is assessed before and after the first session, at 2weeks and 3months later. Grip was measured with the Sollerman test, and the speed and global function of the affected arm with the Box–Block test. ResultsIn the 1st session in Box–Block it went from 18.6 to 22.6 cubes (P<.002). Results maintained in 2nd and 3rd evaluation. In the Sollerman test, it went from an average of 41.4–46.9 pts. (p<.003) in 1st evaluation, and 47.15 pts. in 2nd (P<0.002). After 3months the effects are maintained (.005). ConclusionsThe application of a reflex locomotion program adapted to sitting in patients with sequelae in the upper limb, offers the patient the possibility of self-managing therapy by increasing its intensity. This improves the function and mobility of the upper limb in the short term.