Abstract
BackgroundApproximately half of stroke patients show impaired upper limb and hand function. Task-oriented training focuses on functional tasks, while joint mobilization technique aims to restore the accessory movements of the joints.ObjectiveTo investigate the effect of adding joint mobilization to task-oriented training to help the patients in reaching a satisfactory level of recovery for their hand function.Patients and methodsThirty chronic stroke patients with paretic hand participated in the study; they were divided equally into study and control groups. The study group received joint mobilization followed by task-oriented training for the affected hand. Meanwhile, the control group received task-oriented training only. Both groups received their treatment in the form of 3 sessions per week for 6 successive weeks. The primary outcome measures were hand function that was assessed by Jebsen-Taylor hand function test (JTT) and active and passive wrist extension range of motion (ROM) that was measured by a standard goniometer. The secondary outcome measure was the grip strength of the hand that was assessed by a JAMAR adjustable hand dynamometer.ResultsThere was a significant improvement in all the outcome measurements in both groups that were more evident in the study group.ConclusionCombining joint mobilization with task-oriented training had a highly significant effect in improving the hand function in chronic stroke patients compared to task-oriented training alone.
Highlights
Stroke is defined as a neurological deficit attributed to an acute vascular focal injury of the central nervous system [1]
There was a significant improvement in all the outcome measurements in both groups that were more evident in the study group
Combining joint mobilization with task-oriented training had a highly significant effect in improving the hand function in chronic stroke patients compared to task-oriented training alone
Summary
Stroke is defined as a neurological deficit attributed to an acute vascular focal injury of the central nervous system [1]. Hemiparesis is the most common motor impairment after a stroke and frequently leads to persistent hand dysfunction [3]. About 50% of stroke patients show impaired upper limb and hand. Task-oriented training is a type of physiotherapy that encourages the active participation and focuses on functional tasks rather than simple repetitive training of normal motion patterns [7]. Joint mobilization technique proposed by Maitland is based on a graded system and is intended to restore the accessory movements of the joints by performing passive, rhythmic, and oscillatory movements [9]. Half of stroke patients show impaired upper limb and hand function. Task-oriented training focuses on functional tasks, while joint mobilization technique aims to restore the accessory movements of the joints
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