Exploring a repetitive training regime for upper limb hemiparesis in an in-patient setting: a report on three case studies

Abstract

Primary objective : To explore the efficacy of a task-oriented repetitive training protocol (RTx) in chronic hemiparetic patients in an in-patient rehabilitation unit. Research design : Three case studies; ABAB design (A=RTx; B=regular rehabilitation programme; 1 week per phase, respectively) in case P1, pre-post intervention comparison in case P2; repeated measure design in case P3. Methods and procedures : Daily training of task-oriented affected hand movements using shaping procedures developed in Constraint-Induced (CI) Movement Therapy. Patients 1 and 2 were trained daily for 90 minutes over 2 weeks. Patient 3 received 60 minutes of daily training for a period of 4 weeks. Outcome measures were Wolf Motor Function Test (WMFT), Frenchay Arm Test, nine-hole peg test, upper extremity MRC, and grip force. Main outcomes and results : Substantial clinical benefits were achieved in all patients. The subjective observations mirrored significant improvements in the outcome parameters. Conclusion : The affected hand training improves upper limb motor functions in chronic patients. It is a 'practicable' approach for in-patient rehabilitation units.