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A Study to Assess the Effect of Task Specific Training with Trunk Restraint on Arm Recovery in Stroke Patients


Affiliations
1 T.N. Medical college and B.Y.L.Nair Hospital, Mumbai, India
2 PT, MPTh T.N. Medical College and B.Y.L.Nair Hospital, Mumbai, India
     

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Background : The study was carried out to assess the effect of task specific training with trunk restraint and without trunk restraint on arm recovery in stroke patients. Subjects: 30 stroke patients were included in the study.

Method: Thirty individuals participated after signing ethics-committee approved consent forms. Subjects were randomly divided in two groups - either a physical trunk restraint (TR) or a control group (C).

Along with neurological evaluation of the patients, the performance of the upper limb was characterized using a battery of standardized clinical tests.

They included the Fugl-Meyer test and the TEMPA test, which are two primary clinical outcomes characterizing the effectiveness of the training programme.

In the experimental group,(TR) the trunk was secured to the chair back with a stabilising belt, minimising shoulder girdle movements and preventing trunk flexion/rotation. In control group,(C)the trunk was not restrained. Task-specific training which included manipulation and dexterity tasks, simple active exercises to elicit muscle activity, bimanual practice, brief stretching were given to both the groups.

Results: Significant improvements were found in total score of Fugl-Meyr Scale and TEMPA and ROM of elbow extension in experimental group (TR) as compared to the control group.

Conclusion: Trunk restraint may be effective in uncovering latent movement patterns to maximize arm recovery in hemiparetic patients. Restriction of compensatory trunk movements may encourage recovery of premorbid movement patterns leading to better functional outcomes.


Keywords

Task-specific Training, Trunk Restraint, Degrees of Freedom (DOFs)
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  • Ada L, Canning C, Carr JH, Kilbreath SL, Shepherd RB. Task-specific training of reaching and manipulation. In: Bennet KMB, Castiello U, eds. Insights Into Reach and Grasp Movement. Cambridge, UK: Elsevier-Biosoft; 1994: 239–265.

  • A.P.I’s Textbook of Medicine, 7th Edition, 780-791

  • Bernstein NA, Buravtseva GR. Coordination Disturbances and Restitution of the Biodynamics of Gait after Brain Damage. Thesis, 7th Session, Institute of Neurology, Moscow. Academy of Medical Science, 1954. (Russian)

  • Berglund K, Fugl-Meyer AR. Upper extremity function in hemiplegia. A cross validation study of two assessment methods. Scand J Rehabil Med. 1986; 18: 155–157

  • Bobath B. Adult Hemiplegia: Evaluation and treatment.3rd edition, London: Heinmann Medival;1990

  • Carr J & Shepherd R, Optimizing motor performance,126-149

  • Chapman H, Gavrilescu M, Wang H, Kean M, Egan G, Castiello U. Posterior parietal cortex control of reach-to-grasp movements in humans. Eur J Neurosci. 2002 Jun;15(12):2037-42

  • Chieffi S; Gentilucci M Coordination between the transport and the grasp components during prehension movements. Experimental brain research. Experimentelle Hirnforschung. Experimentation cerebrale, (1993) Vol. 94, No. 3, pp. 471-7

  • Cirstea MC,Levin MF, Compensatory strategies for reaching in stroke. Brain.2000;123: 940-953.

  • Cirstea MC, Ptito A, Levin MF. Arm reaching improvements with short-term practice depend on the severity of the motor deficit in stroke. Exp Brain Res. 2003; 152: 476–488.

  • Cirstea MC, Mitnitski AB, Feldman AG, Levin MF. Coordination dynamics during reaching in stroke. Exp Brain Res. 2003; 151: 289–300

  • Desrosiers J, Hebert R, Dutil E, Bravo G. Development and reliability of an upper extremity function test for the elderly: the TEMPA. Can J Occup Ther. 1993;60:9-16.

  • Desrosiers J, Hebert R, Dutil E, Bravo G, Mercier L. Validity of a measurement instrument for upper extremity performance: the TEMPA. Occup Ther J Res. 1994;14:267-281.

  • Desrosiers J, Hébert R, Dutil É, Bravo R. Development and reliability of an upper extremity function test for the edderly: the TEMPA. Can J Occup Ther 1993;60:9-16.

  • Duncan P, Propst M, Nelson S. Reliability of the Fugl-Meyer assessment of the sensorimotor recovery following cerebrovascular accident.Phys Ther 1983;63:1606-1610.

  • Esparza DY, Archambault PS, Winstein CJ, Levin MF. Hemispheric specialization in the coordination of arm and trunk movements during pointing in patients with unilateral brain damage; Exp Brain Res. 2003 Feb;148(4):488-97. Epub 2002 Dec 21

  • Gentile AM. Skill acquisition: action movement, and neuromotor processes. In: Carr J, Shepherd RB, eds. Movement Science: Foundations for Physical Therapy in Rehabilitation. Rockville, Md: Aspen Systems;1987

  • Johanne Desrosiers, OT, PhD; Daniel Bourbonnais, PhD; Gina Bravo, PhD; Pierre-Michel Roy, MD Manon Guay, BSc (OT) Performance of the ‘Unaffected’ Upper Extremity of Elderly Stroke Patients Stroke. 1996;27: 1564-1570

  • Fugl-Meyer A, Jääskö L, Leyman I, Olsson I, Steglind S. The poststroke hemiplegic patient: a method for evaluation of physical performance. Scan J Rehab Med 1975;7:13-

  • Julie Sanford,Juiie Moreiand, Laurie R Swanson, Paul W Stratfor, Gowiand. Reliability of the Fugl-Meyer Assessment for Testing -Motor Performance in Patients Following Stroke, Physical Therapy/Volume 73, Number 7/July 1993,36-47


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  • A Study to Assess the Effect of Task Specific Training with Trunk Restraint on Arm Recovery in Stroke Patients

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Authors

Hutoxi Writer
T.N. Medical college and B.Y.L.Nair Hospital, Mumbai, India
Neelam K. Nayak
PT, MPTh T.N. Medical College and B.Y.L.Nair Hospital, Mumbai, India

Abstract


Background : The study was carried out to assess the effect of task specific training with trunk restraint and without trunk restraint on arm recovery in stroke patients. Subjects: 30 stroke patients were included in the study.

Method: Thirty individuals participated after signing ethics-committee approved consent forms. Subjects were randomly divided in two groups - either a physical trunk restraint (TR) or a control group (C).

Along with neurological evaluation of the patients, the performance of the upper limb was characterized using a battery of standardized clinical tests.

They included the Fugl-Meyer test and the TEMPA test, which are two primary clinical outcomes characterizing the effectiveness of the training programme.

In the experimental group,(TR) the trunk was secured to the chair back with a stabilising belt, minimising shoulder girdle movements and preventing trunk flexion/rotation. In control group,(C)the trunk was not restrained. Task-specific training which included manipulation and dexterity tasks, simple active exercises to elicit muscle activity, bimanual practice, brief stretching were given to both the groups.

Results: Significant improvements were found in total score of Fugl-Meyr Scale and TEMPA and ROM of elbow extension in experimental group (TR) as compared to the control group.

Conclusion: Trunk restraint may be effective in uncovering latent movement patterns to maximize arm recovery in hemiparetic patients. Restriction of compensatory trunk movements may encourage recovery of premorbid movement patterns leading to better functional outcomes.


Keywords


Task-specific Training, Trunk Restraint, Degrees of Freedom (DOFs)

References