Synergy-based motor therapy for post-stroke hemiparetic subjects: A randomized controlled trial

Abstract

Listen

Translate article

Objectives: Motor recovery is inclusively based on the severity of abnormal coupling or the abnormal synergistic actions among the post-stroke hemiparetic subjects. The normal synergistic pattern shall be incorporated to inhibit the abnormal synergistic behavior to attain motor control. Materials and Methods: A randomized controlled double blinded (assessor and subjects) trial was conducted in a rehabilitation institute. One hundred and thirty-six post-stroke (mean duration, 12.73 ± 9.52 months) hemiparetic subjects were conveniently selected and randomly allocated in two groups (experimental, 68 and control, 68). The experimental group received synergistic-based motor therapy (SBMT) protocol and the control group of the subjects received the conventional occupational therapy intervention. Both of the groups received dose-matched intervention for the period of 3 months, 48 sessions (4/week). Normal synergistic linkage was being exploited to encounter the abnormal synergistic patterns. The main outcome measures were Fugl-Meyer Assessment – upper extremity (FMA-UE), arm (FMA-A), wrist-hand (FMA-WH) for the motor recovery and Finger Breadth Palpation method (FBP) for the shoulder subluxation. Results: In comparison to the control group, the experimental group exhibited highly significant results. The mean score of FMA-UE was changed to 41.32 ± 11.50 from the pre-intervention score of 25.76 ± 15.26 (P < 0.001). Post-intervention, the mean score of FMA-A was increased to 26.89 ± 0.93 from 17.36 ± 1.21 (P < 0.001). The pre-assessment score of FMA-WH was 8.29 ± 0.96 and post-intervention, it was increased to 14.13 ± 0.88 (P < 0.001). The experimental group of subjects was recorded to have a reduction in the shoulder subluxation. The grade of FBP reduced to 0.39 ± 0.11 from the pre-intervention score of 1.23 ± 0.13 (P < 0.001). Conclusion: SBMT was concluded to be superior and highly significant than the conventional intervention for enhancing upper limb motor recovery among post-stroke hemiparetic subjects. Further, the grade of shoulder subluxation was also found to be significantly reduced among the SBMT group participants in comparison to the control subjects.