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EFFICACY OF MODIFIED CONSTRAINT INDUCED MOVEMENT THERAPY FOR LOWER EXTREMITY IN PATIENTS WITH STROKE: STRENGTH AND QUALITY OF LIFE OUTCOMES

Year 2019, Volume: 30 Issue: 1, 23 - 32, 16.04.2019
https://doi.org/10.21653/tfrd.406349

Abstract

Purpose: The purpose of this study was to examine the
efficacy of modified constraint-induced movement therapy (mCIMT), which was
applied to lower extremity, on strength and quality of life in patients with stroke. 

Methods: 30 patients with stroke were randomized to 2
groups. Both groups received first
neurodevelopmental
therapy (NDT) for 4 weeks as baseline treatment following which the study group
received mCIMT and the control group received NDT for 2 weeks as experimental
treatment. All were evaluated 3 times (pre-baseline treatment, post-baseline
treatment, post-experimental treatment) through Motricity Index (MI), Stroke
Impact Scale (SIS) and Stroke Specific Quality of Life (SS-QoL) scale. 

Results: The total score, mobility, self-care, upper
extremity function, thinking, mood, family and social roles subdomain scores of
the SS-QoL significantly increased in the study group, particularly during the experimental
treatment period (p < 0.05). The amount of perceived recovery domain of SIS
was greater in the study group during both the experimental and total treatment
periods (p = 0.000). Significant improvement was observed in paretic lower
extremity strength only in the study group for the total treatment period (p = 0.029).
Correlations between the total change of scores in strength and quality of life
and
the changes in the experimental treatment period
were found strong. 

Conclusion: This study shows that mCIMT is more effective than NDT in patients with stroke to improve paretic lower
extremity strength and health related quality of life.

References

  • REFERENCES1. Ferrarello F, Baccini M, Rinaldi LA, Cavallini MC, Mossello E, Masotti G, et al. Efficacy of physiotherapy interventions late after stroke: a meta-analysis. J Neurol Neurosurg Psychiatry. 2011;82(2):136-43.
  • 2. Group W. The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization. Social science & medicine (1982). 1995;41(10):1403-9.
  • 3. Muus I, Petzold M, Ringsberg KC. Health-related quality of life among Danish patients 3 and 12 months after TIA or mild stroke. Scandinavian journal of caring sciences. 2010;24(2):211-8.
  • 4. Carod-Artal FJ, Trizotto DS, Coral LF, Moreira CM. Determinants of quality of life in Brazilian stroke survivors. Journal of the neurological sciences. 2009;284(1-2):63-8.
  • 5. Pollock A, Baer G, Campbell P, Choo PL, Forster A, Morris J, et al. Physical rehabilitation approaches for the recovery of function and mobility following stroke. The Cochrane database of systematic reviews. 2014(4):Cd001920.
  • 6. Taub E, Uswatte G, Mark VW, Morris DM. The learned nonuse phenomenon: implications for rehabilitation. Europa medicophysica. 2006;42(3):241-56.
  • 7. Billinger SA, Guo LX, Pohl PS, Kluding PM. Single limb exercise: pilot study of physiological and functional responses to forced use of the hemiparetic lower extremity. Topics in stroke rehabilitation. 2010;17(2):128-39.
  • 8. Sibley KM, Tang A, Brooks D, Brown DA, McIlroy WE. Feasibility of adapted aerobic cycle ergometry tasks to encourage paretic limb use after stroke: a case series. Journal of neurologic physical therapy : JNPT. 2008;32(2):80-7.
  • 9. Kallio K, Nilsson-Wikmar L, Thorsén A-M. Modified constraint-induced therapy for the lower extremity in elderly persons with chronic stroke: single-subject experimental design study. Topics in stroke rehabilitation. 2014;21:111-9.
  • 10. Aruin AS, Rao N, Sharma A, Chaudhuri G. Compelled body weight shift approach in rehabilitation of individuals with chronic stroke. Topics in stroke rehabilitation. 2012;19(6):556-63.
  • 11. Zhu Y, Zhou C, Liu Y, Liu J, Jin J, Zhang S, et al. Effects of modified constraint-induced movement therapy on the lower extremities in patients with stroke: a pilot study. Disability and rehabilitation. 2016;38(19):1893-9.
  • 12. Acaroz Candan S, Livanelioğlu A. Effects of modified constraint induced movement therapy for lower limb on motor function in stroke patients: a randomized controlled study International Journal of Physiotherapy. 2017;4(5):269-77.
  • 13. Marklund I, Klassbo M. Effects of lower limb intensive mass practice in poststroke patients: single-subject experimental design with long-term follow-up. Clinical rehabilitation. 2006;20(7):568-76.
  • 14. Zhu Y, Zhou C, Liu Y, Liu J, Jin J, Zhang S, et al. Effects of modified constraint-induced movement therapy on the lower extremities in patients with stroke: a pilot study. Disability and rehabilitation. 2016;38(19):1893-9.
  • 15. Mishra S, Chitra J. Effect of modified constraint induced movement therapy (mCIMT) for lower limb on weight bearing symmetry and balance in stroke patients: a pre-post experimental study. International Journal of Scientific Research. 2014;3(6):485-8.
  • 16. Bayona NA, Bitensky J, Foley N, Teasell R. Intrinsic factors influencing post stroke brain reorganization. Topics in stroke rehabilitation. 2005;12(3):27-36.
  • 17. Cameron D, Bohannon RW. Criterion validity of lower extremity Motricity Index scores. Clin Rehabil. 2000;14(2):208-11.
  • 18. Fayazi M, Dehkordi SN, Dadgoo M, Salehi M. Test-retest reliability of Motricity Index strength assessments for lower extremity in post stroke hemiparesis. Medical journal of the Islamic Republic of Iran. 2012;26(1):27-30.
  • 19. Duncan PW, Wallace D, Lai SM, Johnson D, Embretson S, Laster LJ. The stroke impact scale version 2.0. Evaluation of reliability, validity, and sensitivity to change. Stroke. 1999;30(10):2131-40.
  • 20. Hantal AÖ, Doğu B, Büyükavcı R, Kuran B. İnme etki ölçeği 3, 0: Türk toplumundaki inmeli hastalarda güvenilirlik ve geçerlilik çalışması. Türk Fiz Tıp Rehab Derg. 2014;60:106-16.
  • 21. Muren MA, Hutler M, Hooper J. Functional capacity and health-related quality of life in individuals post stroke. Topics in stroke rehabilitation. 2008;15(1):51-8.
  • 22. Williams LS, Weinberger M, Harris LE, Clark DO, Biller J. Development of a stroke-specific quality of life scale. Stroke. 1999;30(7):1362-9.
  • 23. Morris DM, Taub E. Constraint-induced therapy approach to restoring function after neurological injury. Topics in stroke rehabilitation. 2001;8(3):16-30.
  • 24. Evans JD. Straightforward statistics for the behavioral sciences. Pacific Grove: Brooks/Cole Pub. Co.; 1996.
  • 25. Numata K, Murayama T, Takasugi J, Oga M. Effect of modified constraint-induced movement therapy on lower extremity hemiplegia due to a higher-motor area lesion. Brain injury. 2008;22(11):898-904.
  • 26. Carod-Artal J, Egido JA, Gonzalez JL, Varela de Seijas E. Quality of life among stroke survivors evaluated 1 year after stroke: experience of a stroke unit. Stroke. 2000;31(12):2995-3000.
  • 27. Lin KC, Fu T, Wu CY, Hsieh CJ. Assessing the stroke-specific quality of life for outcome measurement in stroke rehabilitation: minimal detectable change and clinically important difference. Health and quality of life outcomes. 2011;9:5.
  • 28. Yu WH, Liu WY, Wong AM, Wang TC, Li YC, Lien HY. Effect of forced use of the lower extremity on gait performance and mobility of post-acute stroke patients. Journal of physical therapy science. 2015;27(2):421-5.

EFFICACY OF MODIFIED CONSTRAINT-INDUCED MOVEMENT THERAPY FOR LOWER EXTREMITY IN PATIENTS WITH STROKE: STRENGTH AND QUALITY OF LIFE OUTCOMES

Year 2019, Volume: 30 Issue: 1, 23 - 32, 16.04.2019
https://doi.org/10.21653/tfrd.406349

Abstract

Purpose: This study was aimed to examine the efficacy of modified constraint-induced movement therapy (mCIMT), which was applied to lower extremity, on strength and quality of life (QoL) in patients with stroke.

Methods: Thirty patients with stroke were randomly divided into two groups. Both groups received neuro-developmental therapy (NDT) for four weeks as baseline treatment. After four weeks, when the study group received mCIMT, the control group continued NDT for two weeks as the experimental treatment. The strength was evaluated using Motricity Index, and QoL was evaluated using Stroke Specific Quality of Life Scale (SS-QoL), and Stroke Impact Scale (SIS) for three times (baseline, post 4 weeks, and post 6 weeks).

Results: The strength and QoL improved in both groups for all treatment periods (p<0.01). The paretic lower limb strength developed more in the mCIMT group for the total treatment period (p=0.029). The total score of the SS-QoL and mobility, self-care, thinking, mood, family, and social roles subdomain scores of the SS-QoL were more pronounced in the mCIMT group after the mCIMT period (p<0.05). The amount of perceived recovery domain of SIS was greater in the mCIMT group after mCIMT and total treatment periods according to the control group (p<0.001). The total changes in strength and QOL were strongly correlated with the improvement in the mCIMT period (r=0.709, p<0.01 and r=0.769, p<0.01) than in the baseline period (r=0.660, p<0.01 and r=0.505, p<0.01).

Conclusion: The study showed that mCIMT could be used as an effective treatment method for patients with stroke to improve paretic lower extremity strength and health-related QoL.

References

  • REFERENCES1. Ferrarello F, Baccini M, Rinaldi LA, Cavallini MC, Mossello E, Masotti G, et al. Efficacy of physiotherapy interventions late after stroke: a meta-analysis. J Neurol Neurosurg Psychiatry. 2011;82(2):136-43.
  • 2. Group W. The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization. Social science & medicine (1982). 1995;41(10):1403-9.
  • 3. Muus I, Petzold M, Ringsberg KC. Health-related quality of life among Danish patients 3 and 12 months after TIA or mild stroke. Scandinavian journal of caring sciences. 2010;24(2):211-8.
  • 4. Carod-Artal FJ, Trizotto DS, Coral LF, Moreira CM. Determinants of quality of life in Brazilian stroke survivors. Journal of the neurological sciences. 2009;284(1-2):63-8.
  • 5. Pollock A, Baer G, Campbell P, Choo PL, Forster A, Morris J, et al. Physical rehabilitation approaches for the recovery of function and mobility following stroke. The Cochrane database of systematic reviews. 2014(4):Cd001920.
  • 6. Taub E, Uswatte G, Mark VW, Morris DM. The learned nonuse phenomenon: implications for rehabilitation. Europa medicophysica. 2006;42(3):241-56.
  • 7. Billinger SA, Guo LX, Pohl PS, Kluding PM. Single limb exercise: pilot study of physiological and functional responses to forced use of the hemiparetic lower extremity. Topics in stroke rehabilitation. 2010;17(2):128-39.
  • 8. Sibley KM, Tang A, Brooks D, Brown DA, McIlroy WE. Feasibility of adapted aerobic cycle ergometry tasks to encourage paretic limb use after stroke: a case series. Journal of neurologic physical therapy : JNPT. 2008;32(2):80-7.
  • 9. Kallio K, Nilsson-Wikmar L, Thorsén A-M. Modified constraint-induced therapy for the lower extremity in elderly persons with chronic stroke: single-subject experimental design study. Topics in stroke rehabilitation. 2014;21:111-9.
  • 10. Aruin AS, Rao N, Sharma A, Chaudhuri G. Compelled body weight shift approach in rehabilitation of individuals with chronic stroke. Topics in stroke rehabilitation. 2012;19(6):556-63.
  • 11. Zhu Y, Zhou C, Liu Y, Liu J, Jin J, Zhang S, et al. Effects of modified constraint-induced movement therapy on the lower extremities in patients with stroke: a pilot study. Disability and rehabilitation. 2016;38(19):1893-9.
  • 12. Acaroz Candan S, Livanelioğlu A. Effects of modified constraint induced movement therapy for lower limb on motor function in stroke patients: a randomized controlled study International Journal of Physiotherapy. 2017;4(5):269-77.
  • 13. Marklund I, Klassbo M. Effects of lower limb intensive mass practice in poststroke patients: single-subject experimental design with long-term follow-up. Clinical rehabilitation. 2006;20(7):568-76.
  • 14. Zhu Y, Zhou C, Liu Y, Liu J, Jin J, Zhang S, et al. Effects of modified constraint-induced movement therapy on the lower extremities in patients with stroke: a pilot study. Disability and rehabilitation. 2016;38(19):1893-9.
  • 15. Mishra S, Chitra J. Effect of modified constraint induced movement therapy (mCIMT) for lower limb on weight bearing symmetry and balance in stroke patients: a pre-post experimental study. International Journal of Scientific Research. 2014;3(6):485-8.
  • 16. Bayona NA, Bitensky J, Foley N, Teasell R. Intrinsic factors influencing post stroke brain reorganization. Topics in stroke rehabilitation. 2005;12(3):27-36.
  • 17. Cameron D, Bohannon RW. Criterion validity of lower extremity Motricity Index scores. Clin Rehabil. 2000;14(2):208-11.
  • 18. Fayazi M, Dehkordi SN, Dadgoo M, Salehi M. Test-retest reliability of Motricity Index strength assessments for lower extremity in post stroke hemiparesis. Medical journal of the Islamic Republic of Iran. 2012;26(1):27-30.
  • 19. Duncan PW, Wallace D, Lai SM, Johnson D, Embretson S, Laster LJ. The stroke impact scale version 2.0. Evaluation of reliability, validity, and sensitivity to change. Stroke. 1999;30(10):2131-40.
  • 20. Hantal AÖ, Doğu B, Büyükavcı R, Kuran B. İnme etki ölçeği 3, 0: Türk toplumundaki inmeli hastalarda güvenilirlik ve geçerlilik çalışması. Türk Fiz Tıp Rehab Derg. 2014;60:106-16.
  • 21. Muren MA, Hutler M, Hooper J. Functional capacity and health-related quality of life in individuals post stroke. Topics in stroke rehabilitation. 2008;15(1):51-8.
  • 22. Williams LS, Weinberger M, Harris LE, Clark DO, Biller J. Development of a stroke-specific quality of life scale. Stroke. 1999;30(7):1362-9.
  • 23. Morris DM, Taub E. Constraint-induced therapy approach to restoring function after neurological injury. Topics in stroke rehabilitation. 2001;8(3):16-30.
  • 24. Evans JD. Straightforward statistics for the behavioral sciences. Pacific Grove: Brooks/Cole Pub. Co.; 1996.
  • 25. Numata K, Murayama T, Takasugi J, Oga M. Effect of modified constraint-induced movement therapy on lower extremity hemiplegia due to a higher-motor area lesion. Brain injury. 2008;22(11):898-904.
  • 26. Carod-Artal J, Egido JA, Gonzalez JL, Varela de Seijas E. Quality of life among stroke survivors evaluated 1 year after stroke: experience of a stroke unit. Stroke. 2000;31(12):2995-3000.
  • 27. Lin KC, Fu T, Wu CY, Hsieh CJ. Assessing the stroke-specific quality of life for outcome measurement in stroke rehabilitation: minimal detectable change and clinically important difference. Health and quality of life outcomes. 2011;9:5.
  • 28. Yu WH, Liu WY, Wong AM, Wang TC, Li YC, Lien HY. Effect of forced use of the lower extremity on gait performance and mobility of post-acute stroke patients. Journal of physical therapy science. 2015;27(2):421-5.
There are 28 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Sevim Acaröz Candan

Ayşe Livanelioğlu This is me

Publication Date April 16, 2019
Published in Issue Year 2019 Volume: 30 Issue: 1

Cite

APA Acaröz Candan, S., & Livanelioğlu, A. (2019). EFFICACY OF MODIFIED CONSTRAINT INDUCED MOVEMENT THERAPY FOR LOWER EXTREMITY IN PATIENTS WITH STROKE: STRENGTH AND QUALITY OF LIFE OUTCOMES. Fizyoterapi Rehabilitasyon, 30(1), 23-32. https://doi.org/10.21653/tfrd.406349
AMA Acaröz Candan S, Livanelioğlu A. EFFICACY OF MODIFIED CONSTRAINT INDUCED MOVEMENT THERAPY FOR LOWER EXTREMITY IN PATIENTS WITH STROKE: STRENGTH AND QUALITY OF LIFE OUTCOMES. Fizyoterapi Rehabilitasyon. April 2019;30(1):23-32. doi:10.21653/tfrd.406349
Chicago Acaröz Candan, Sevim, and Ayşe Livanelioğlu. “EFFICACY OF MODIFIED CONSTRAINT INDUCED MOVEMENT THERAPY FOR LOWER EXTREMITY IN PATIENTS WITH STROKE: STRENGTH AND QUALITY OF LIFE OUTCOMES”. Fizyoterapi Rehabilitasyon 30, no. 1 (April 2019): 23-32. https://doi.org/10.21653/tfrd.406349.
EndNote Acaröz Candan S, Livanelioğlu A (April 1, 2019) EFFICACY OF MODIFIED CONSTRAINT INDUCED MOVEMENT THERAPY FOR LOWER EXTREMITY IN PATIENTS WITH STROKE: STRENGTH AND QUALITY OF LIFE OUTCOMES. Fizyoterapi Rehabilitasyon 30 1 23–32.
IEEE S. Acaröz Candan and A. Livanelioğlu, “EFFICACY OF MODIFIED CONSTRAINT INDUCED MOVEMENT THERAPY FOR LOWER EXTREMITY IN PATIENTS WITH STROKE: STRENGTH AND QUALITY OF LIFE OUTCOMES”, Fizyoterapi Rehabilitasyon, vol. 30, no. 1, pp. 23–32, 2019, doi: 10.21653/tfrd.406349.
ISNAD Acaröz Candan, Sevim - Livanelioğlu, Ayşe. “EFFICACY OF MODIFIED CONSTRAINT INDUCED MOVEMENT THERAPY FOR LOWER EXTREMITY IN PATIENTS WITH STROKE: STRENGTH AND QUALITY OF LIFE OUTCOMES”. Fizyoterapi Rehabilitasyon 30/1 (April 2019), 23-32. https://doi.org/10.21653/tfrd.406349.
JAMA Acaröz Candan S, Livanelioğlu A. EFFICACY OF MODIFIED CONSTRAINT INDUCED MOVEMENT THERAPY FOR LOWER EXTREMITY IN PATIENTS WITH STROKE: STRENGTH AND QUALITY OF LIFE OUTCOMES. Fizyoterapi Rehabilitasyon. 2019;30:23–32.
MLA Acaröz Candan, Sevim and Ayşe Livanelioğlu. “EFFICACY OF MODIFIED CONSTRAINT INDUCED MOVEMENT THERAPY FOR LOWER EXTREMITY IN PATIENTS WITH STROKE: STRENGTH AND QUALITY OF LIFE OUTCOMES”. Fizyoterapi Rehabilitasyon, vol. 30, no. 1, 2019, pp. 23-32, doi:10.21653/tfrd.406349.
Vancouver Acaröz Candan S, Livanelioğlu A. EFFICACY OF MODIFIED CONSTRAINT INDUCED MOVEMENT THERAPY FOR LOWER EXTREMITY IN PATIENTS WITH STROKE: STRENGTH AND QUALITY OF LIFE OUTCOMES. Fizyoterapi Rehabilitasyon. 2019;30(1):23-32.