Induced Movement Therapy Research Articles

Effect of Modified Constrained Induced Movement Therapy Principles with Therapeutic Clay Moulding Exercises on Quality of Hand Function in Post-Stroke Individuals

Effect of Modified Constrained Induced Movement Therapy Principles with Therapeutic Clay Moulding Exercises on Quality of Hand Function in Post-Stroke Individuals

Aplicación de terapia de restricción del lado sano para el tratamiento de la mano espástica del adulto con hemiplejía. Revisión sistemática

Aplicación de terapia de restricción del lado sano para el tratamiento de la mano espástica del adulto con hemiplejía. Revisión sistemática

Exploration of barriers and enablers for evidence-based interventions for upper limb rehabilitation following a stroke: Use of Constraint Induced Movement Therapy and Robot Assisted Therapy in NHS Scotland

Introduction The routine use of evidence-based upper limb rehabilitation interventions after stroke has the potential to improve function and increase independence. Two such interventions are Constraint Induced Movement Therapy and Robot Assisted Therapy. Despite evidence to support both interventions, their use within the National Health Service appears, anecdotally, to be low. We sought to understand user perceptions in order to explain low uptake in clinical practice. Methods A combination of a cross-sectional online survey with therapists and semi-structured interviews with stroke patients was used to explore uptake and user opinions on the benefits, enablers and barriers to each intervention. Findings The therapists surveyed reported low use of Constraint Induced Movement Therapy and Robot Assisted Therapy in clinical practice within the Scottish National Health Service. Barriers identified by therapists were inadequate staffing, and a lack of training and resources. Interviews with stroke patients identified themes that may help us to understand the acceptability of each intervention, such as the impact of motivation. Conclusion Barriers to the uptake of Constraint Induced Movement Therapy and Robot Assisted Therapy within the clinical setting were found to be similar. Further qualitative research should be completed in order to help us understand the role patient motivation plays in uptake.

Compare The Effectiveness of Modified Constraint Induced Movement Therapy (mCIMT) and Mirror Therapy (MT) in Stroke Patients Based on Severity

Compare The Effectiveness of Modified Constraint Induced Movement Therapy (mCIMT) and Mirror Therapy (MT) in Stroke Patients Based on Severity

Study of risk factors and its correlation with constraint induced movement therapy for atherosclerosis in patients of coronary artery disease and their offspring

Background: A significant percent of cardiovascular event occurs without well-known modifiable risk. A new tool for early identification for atherosclerosis is required for early intervention. Aims and objectives of the study was to study the risk factors for CAD and its correlation with CIMT.Methods: One hundred and forty subjects were studied for the risk factors of CAD in Department of Medicine of G.R. Medical College, Gwalior from 2012 to 2013. Out of 140 subjects, 100 were patients having CAD and 40 age matched subjects were included as control group. Data was also recorded from their offspring. High resolution B mode ultrasonography was performed to assess CIMT of carotid arteries. The maximum CIMT of any one side of carotid artery was taken for study.Results: CAD was more prevalent among males (78%). Majority of the offspring of cases had age between 28-42 years and majority were male (73%). Most common risk factors for CAD was dyslipidemia (48%), hypertension (24%), diabetes (12%) and smoking (21%), whereas in offspring’s of CAD patients, dyslipidemia was seen in 28%, hypertension in 3%, diabetes and tobacco smoking in 12% and 24% respectively. The CIMT of CAD patients was significantly increased with increasing the number of risk factors and the same pattern was also seen in controls. The CIMT of asymptomatic offspring’s having positive family history was significantly more than the asymptomatic offspring without positive family history of CAD.Conclusions: CIMT measurements can be used as a surrogate marker of atherosclerosis as it has showed a direct link with number of risk factors of CAD.

Challenges During Modified Constraint Induced Movement Therapy (mCIMT) in Hemiplegic Cerebral Palsy

Two cases involving children with hemiplegic cerebral palsy aged 1 and 8 year receiving mCIMT were reported. Challenges faced by the clinicians and family members were discussed in detail. mCIMT is rarely implemented in pediatric rehabilitation in Malaysia. The intensive protocol of mCIMT yielded challenges in terms of high commitment from the family members and non-adherence from the children. Clinicians and family members should properly plan and discuss when consideringmCIMT for intervention.International Journal of Human and Health Sciences Vol. 04 No. 03 July’20 Page : 229-231

RTMS and CIMT for Neurofunctional Recovery in Chronic Stroke

Background: The purpose of the study was to investigate the effect of high frequency rTMS with constraint induced movement therapy (CIMT) on Upper extremity motor function. Clinical Stroke Assessment Scales and fMRI was used to assess the response of CIMT with rTMS on blood oxygenation-level dependent (BOLD) sequence component. Methodology: RCT was conducted at All India Institute of Medical Sciences, New Delhi, on chronic stroke patients (N=60) between 12 to 36 months of index event with atleast 10° of wrist extension, 10° of thumb abduction, Brunnstorm stage 2-4; NIHSS 4–20. Patients were randomized to CIMT alone (Group A n=30) & rTMS with CIMT (Group B n=30). rTMS (10 Hz, 750 pulses with 110%RMT) was administered for 3 weeks (5days/week). Radiological Assessment of the patients was done with fMRI (BOLD) along with assessment of Fugl Meyer (FM), Barthel Index, and modified Rankin Scales (MRS) at baseline, 3 weeks (Post intervention) & 3 month (follow up) Results: FM showed statistically significant improvement in group B as compared to group A at 3 weeks (95%CI: -12.4 to -9.3, p=0.003) and 3months (95%CI: 7.4 to 4.2, p=0.01). Repeated measure ANOVA showed that the mean groups were different at all-time points indicating some degree of improvement in all the subjects (F=3.4, p=0.01; F=5.4, p=0.002). The BOLD cluster activation was compared between two groups; there was increase in the number of clusters found in Group B. Conclusion: Both the groups showed improvement, increased cluster count showing alterations in cortical activations (fMRI-BOLD) after CIMT with rTMS in patients with chronic stroke indicated more degree of clinical improvement in upper extremity function.

Physiotherapy applied to the upper extremity in 0 to 10-year-old children with obstetric brachial palsy: a systematic review

Obstetric brachial palsy is involved with affected upper limb, resulting in permanent structural and function sequelae that limit the motion articular range and reduce independence in daily activities, as well as the children participation in their natural environment. To describe the physiotherapy treatments currently used to increase the affected upper limb functionality in children from 0 to 10 years diagnosed with obstetric brachial palsy. A bibliographic search of published studies between 2009 and 2018 was carried out in the PubMed, PEDro, ScienceDirect and The Cochrane Library databases. After applying the inclusion/exclusion criteria, ten studies were obtained with favorable results for the affected upper limb functionality and bone mineralization density, regardless of the technique of choice used during the intervention. The used physiotherapy programs in the different studies such as Constraint Induced movement therapy, kinesiotape, electrotherapy, virtual reality and use of splints or orthotics were analyzed. All the described techniques suggest favorable results for the affected upper limb functionality in obstetric brachial palsy from 0 to 10 years.

Effects of Virtual Rehabilitation and Constraint Induced Movement Therapy on Brain Derived Neurotrophic Factor Mediated Motor Improvement in Stroke Patients

Objectives: To carry out a comparison between serum BDNF levels as well as enhancement in upper limb motor function in terms of gross movement, pinch, grip, primary grasp, pre and post intervention in the study and control groups. Study design And Setting: It was a Randomized Control Study conducted from March 2015 to March 2016 at Holy Family Hospital Rawalpindi in collaboration with the Multidisciplinary research laboratory at Islamic International Medical College, Rawalpindi. Methodology: In this study; forty stroke patients were randomly designated to either the study group or the control group. Upper limb activity capability which was quantified by Action Research Arm Test (ARAT) and serum Brain Derived Neurotrophic Factor (BDNF) was measured in both control and study group. The control group underwent traditional upper limb physiotherapy for 16 sessions. The study group underwent Constraint Induced Movement Therapy for the upper limb in combination with the use of motion capture video gaming technology for 16 sessions each of twenty minutes duration. Before and after completion of intervention sessions; ARAT and serum BDNF were measured and compared in both control and study groups. Results: Serum BDNF levels was significantly improved in study group as compare to control group (p<0.001). ARAT showed significant improvement in study group participants as compare to control groups (p<0.001). Conclusion: Virtual rehabilitation was an efficacious method for Neuroplastic enhancement in stroke patients

Immediate and Long-term Effects Of Constraint Induced Movement Therapy in Traumatic Brain Injury Patients

Immediate and Long-term Effects Of Constraint Induced Movement Therapy in Traumatic Brain Injury Patients

A Pilot Study of Constraint Induced Movement Therapy in Preschool Cerebral Palsy After Botulism Toxin Injection

A Pilot Study of Constraint Induced Movement Therapy in Preschool Cerebral Palsy After Botulism Toxin Injection

Modified Constrained Induced Movement Therapy Versus Mirror Therapy Analysis through Fugl-Meyer and Nine Hole Peg Scales

Modified Constrained Induced Movement Therapy Versus Mirror Therapy Analysis through Fugl-Meyer and Nine Hole Peg Scales

Occupational Performance Issues of Children with Hemiplegia after Acquired Brain Injury

Aims: This retrospective, exploratory study aimed to examine the categories and frequency of occupational performance issues (OPIs) identified by children (or their caregivers), who participated in a two-week, group-based modified constraint induced movement therapy program, Helping Hand. The effect of participant age on the OPIs identified was also explored.Methods: OPIs were identified using the Canadian Occupational Performance Measure for 46 Helping Hand participants, prior to program participation. Descriptive statistics including the frequency of identified OPIs were used to categorize the 236 OPIs into occupational areas. Descriptive statistics were also used to determine how the categories of OPIs and relative frequencies differed based on participant age.Results: The identified OPIs were diverse, and differed in frequency of identification and level of specificity. The OPIs identified varied based on participant age, with age groups showing developmentally appropriate differences in OPIs.Conclusions: Identification of OPIs should balance client-centredness with probing for specificity, in order for OPIs to be understood by clinicians. This will guide future program development and interventions that target age-appropriate occupational priorities.

A Cortico- Basal Ganglia Model for choosing an optimal rehabilitation strategy in Hemiparetic Stroke

To facilitate the selection of an optimal therapy for a stroke patient with upper extremity hemiparesis, we propose a cortico-basal ganglia model capable of performing reaching tasks under normal and stroke conditions. The model contains two hemispherical systems, each organized into an outer sensory-motor cortical loop and an inner basal ganglia (BG) loop, controlling their respective hands. The model is trained to simulate two therapeutic approaches: the constraint induced movement therapy (CIMT) in which the intact is arrested, and Bimanual Reaching in which the movements of the intact arm are found to aid the affected arm. Which of these apparently mutually conflicting approaches is right for a given patient? Based on our study on the effect of lesion size on arm performance, we hypothesize that the choice of the therapy depends on the lesion size. Whereas bimanual reaching is more suitable for smaller lesion size, CIMT is preferred in case of larger lesion sizes. By virtue of the model’s ability to capture the experimental results effectively, we believe that it can serve as a benchmark for the development and testing of various rehabilitation strategies for stroke.

Why Do Clinical Practice Guidelines Get Stuck during Implementation and What Can Be Done: A Case Study in Pediatric Rehabilitation

Aims: The purpose of this study was to obtain the perspectives of occupational and physical therapists working in pediatric rehabilitation about the factors that influence implementation of clinical practice guidelines (CPG) using the case of constraint induced movement therapy (CIMT). We aimed to identify factors that hinder implementation of CPGs and strategies for overcoming barriers when widespread implementation is stalled.Methods: Qualitative case study methodology was bounded within the parameters of CIMT implementation in pediatric rehabilitation in one jurisdiction. Twenty-one occupational and physical therapists participated in one of three focus groups. Data were analyzed using an inductive qualitative approach.Results: Participants viewed CPGs as useful, and emphasized the importance of consistency between guidelines and relevance to practice context. Therapists considered the “art and science” in clinical decision-making. Barriers and facilitators to CPG implementation were identified at the client, clinician, intervention location and systemic level. Potential solutions to help “unstick” guideline implementation were consistent with theories of collective knowledge exchange and mindlines.Conclusion: The presence of CPGs does not ensure evidence uptake; understanding of local barriers is required. This case study highlights the value of a collective knowledge exchange approach and attention to the social structures of knowledge development and evidence use.

Current therapy for the upper limb after stroke: a cross-sectional survey of UK therapists

ObjectivesTo survey the reported content, frequency and duration of upper limb treatment provided by occupational and physiotherapists for people after stroke in the UK.DesignA cross-sectional online survey was used. Description...

Measuring the Efficacy of Multiple Dosages of Pediatric Constraint-Induced Movement Therapy (pCIMT) in Young Children With Hemiparesis

Abstract Date Presented 04/05/19 This poster will discuss a research study measuring the effects of multiple dosages of a pediatric constraint induced movement therapy (pCIMT) summer camp program for children two to six years of age. Children attended two summer CIMT programs two years in a row and were assessed using the same outcomes. Methodology and results will be shared. Primary Author and Speaker: Katherine Ryan-Bloomer Additional Authors and Speakers: Michelle Deves, Haley Padgett, Nichelle Meyer, Jenna Richardson, Jordan Shy, Bethany Tackett

Improving postural symmetry: The effectiveness of the CATCH (Combined Approach to Treatment for Children with Hemiplegia) protocol.

To evaluate postural symmetry in sitting and standing for children with hemiplegic cerebral palsy (hCP) following the Combined Approach to Treatment for Children with Hemiplegia (CATCH) protocol, an intervention combining Constraint Induced Movement Therapy, Bimanual Intensive Therapy and Neuro-Developmental Treatment. The study included 10 children with a diagnosis of hCP and 10 typically developing age-matched peers. Subjects participated in a CATCH camp for six hours daily for eight consecutive days. Postural symmetry measurements in quiet sitting and standing were obtained using a Boditrak pressure-mapping system at four time points: prior to start of camp (T1), first day of camp (T2), last day of camp (T3), and one month post-camp (T4). Significant differences (p< 0.05) were found in quiet sitting when comparing postural symmetry pre-intervention and one-month post camp. In quiet standing, significant differences (p< 0.05) were found when pre-intervention was compared to one-month post-intervention. One month post-intervention, the intervention group showed no significant difference from the comparison group. Children with hCP demonstrate improvement in postural symmetry in sitting and standing following participation in a CATCH camp. Following the intervention, children with hCP continued to improve postural symmetry and approach age-matched peers.

Rehabilitation of Neonatal Brachial Plexus Palsy: Integrative Literature Review.

This integrative literature review has been carried out with the aim of analyzing the scientific literature aimed at identifying and describing existing rehabilitation treatments/therapies for neonatal brachial plexus palsy (NBPP). NBPP is a frequent consequence of difficult birthing, and it impairs the function of the brachial plexus in newborns. This is why knowledge on rehabilitation strategies deserves special attention. The data collection was carried out in January 2019, in the EBSCOhost and BVS (Biblioteca Virtual em Saúde) platforms, in the CINAHL Complete, MEDLINE Complete, LILACS and PubMed databases. Thirteen articles were included in this integrative literature review, based on a literature search spanning title, abstract and full text, and considering the inclusion criteria. Two main treatments/therapies for NBPP rehabilitation were identified: conservative treatment and surgical treatment. Conservative treatment includes teamwork done by physiatrists, physiotherapists and occupational therapists. These professionals use rehabilitation techniques and resources in a complementary way, such as electrostimulation, botulinum toxin injection, immobilizing splints, and constraint induced movement therapy of the non-injured limb. Professionals and family members work jointly. Surgical treatment includes primary surgeries, indicated for children who do not present any type of spontaneous rehabilitation in the first three months of life; and secondary surgeries, recommended in children who after primary surgery have some limitation of injured limb function, or in children who have had some spontaneous recovery, yet still have significant functional deficits. Treatment options for NBPP are defined by clinical evaluation/type of injury, but regardless of the type of injury, it is unanimous that conservative treatment is always started as early as possible. It should be noted that there was no evidence in the literature of other types of rehabilitation and techniques used in clinical practice, such as preventive positioning of contractures and deformities, hydrotherapy/aquatic therapy, among others, so we consider there is a need for further studies at this level in this area.

Constraint induced movement therapy promotes contralesional-oriented structural and bihemispheric functional neuroplasticity after stroke

The mechanism behind constraint-induced movement therapy (CIMT) in promoting motor recovery after stroke remains unclear. We explored the bilateral structural and functional reorganization of the brain induced by CIMT after left middle cerebral artery occlusion (MCAO) in rats. CIMT started on the 8th day (D8) after MCAO surgery and lasted for 3 weeks. Skilled walking was assessed by Foot-Fault tests. The efferent neuron network innervating the paralyzed forelimb was labeled by pseudorabies virus (PRV) to explore neuron recruitment. Synapsin Ⅰ was used as an indicator of the number of synapses. Additionally, C-fos expression 1 h after walking was detected to explore the activation of the brain. As a result, CIMT significantly improved skilled walking and elicited more neuron recruitment into the innervating network of a paralyzed forelimb in the contralesional rather than the ipsilesional motor cortex and red nucleus. CIMT also increased the synapse number in the contralesional cortex but there was no corresponding effect in the intact ipsilesional cortex. Furthermore, MCAO decreased ipsilesional motor cortex activation, but CIMT partially compensated for this by increasing the number of activated neurons (c-fos+) in both the left and right motor cortex. In conclusion, the contralesional motor cortex and red nucleus might play more important roles than corresponding ipsilesional regions in structural reorganization during CIMT-induced motor recovery after stroke. However, CIMT promotes bilateral motor cortex activity without a side preference.