Abstract
Introduction. Paresis of hand has severe impact on the life of the stroke patients. Modified constrained induced movement therapy (mCIMT) can be used to treat the involved limb of the patient. It involves constraining of functional hand and increasing the activity of paretic hand which overcomes the “learned disuse” that develops following stroke but the constraining also creates difficulties for the patient and reduces his/her compliance to the treatment. Hence this trial aims to study the effect of mCIMT with and without interval to see if providing relaxation in between the treatment would be able to produce similar effect as mCIMT without interval protocol. Matgerial and methods. 44 patients were recruited in the study and were divided in to three groups: mCIMT without interval (n = 18), mCIMT with interval (n = 16) and control group (n = 10). Participants in three groups were examined for pain and functionality of hand through Patient rated wrist hand evaluation score and Box and Block test at pre and post intervention. The intervention was given for 6 days/week for two weeks. Therapy time was 2 hours and constrain was for 6 hours a day. Clinical trial registration number -CTRI/2019/12/022547. Results. No baseline differences were found in between the three groups. There was significant increase in box and block test score and significant decrease in PRWHE score in pre and post treatment readings for with and without interval mCIMT but non-significant changes in PRWHE score and box and block test were seen in control group. Conclusion. Both interval and without interval mCIMT was effective. Interval mCIMT was seen to be more comfortable than without interval mCIMT for the patient.
Highlights
Paresis of hand has severe impact on the life of the stroke patients
Control group comprised of range of motion exercises which were performed by patient with some stretching for 2 hours during therapy session without any constrain
The analysis showed the statistical significant difference in intervention groups as compared to control group
Summary
Stroke is one of the global health problem and leading reason of crippling affliction for adults [1]. Major complications of stroke include Thromboembolic disease, pneumonia, urinary tract infection, bladder dysfunction, bowel dysfunction, pressure sore, shoulder dysfunction, contractures, seizures, fracture and insomnia. These complications can be reduced by proper care and hygiene of the patient [11]. It has been seen that only 32% of patients follow CIMT restriction schedule To deal with this drawback Page and colleagues created a Modified CIMT (mCIMT) protocol that compressed both the vigorous training session of the paretic upper extremity (30 min/d – 2 h/ day) and constrain time of non-paretic upper extremity (6 h/d) [16,17]. A comparative study between the outcomes of constraining patient continuously and with intervals during mCIMT protocol is needed. The rationale of the study was to evaluate the efficacy of mCIMT with or without interval
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