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Constraint Induced Movement Therapy Paper

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31 October 2014
Modified and Traditional Constraint-Induced Movement Therapy In 50-70 year-old individuals who has suffered a stroke (either hemorrhagic or ischemic) at least 1 month from onset of accident, how does modified or traditional constraint-induced movement therapy (CIMT) compared to a more traditional therapy approach in allowing patients to return to performing functional activities of daily living?
According to Go et al1, an American dies from a stroke every 4 minutes. In the United States, stroke is the 4th leading cause of death and major cause of a serious and long-term disability.1 A stroke occurs when the blood supply is disrupted to the brain or a blood vessel ruptures in the brain, which can defined as an ischemic stroke …show more content…
Both the CIMT and traditional therapy group underwent a 10-day intervention period. The CIMT group wore a shoulder sling for 90% of the time throughout the day and performed 4 hours of supervised activities with affected limb. The control group received the same amount of 4 hours of therapy, but focused on compensatory mechanisms to achieve ADLs, strength and ROM exercises, and positional and mobility training. Based on the outcome measures of functional level for hemiparetic upper extremity, Motor Activity Log, Action Research Arm Test, and modified Barthel Index, greater improvements were observed in each of the outcome measurements with the CIMT group following 10-day period as well as 12-week follow-up.2 Brogårdh et al3 found that CIMT also exhibits a long-term effect and benefit in patients with a mild to moderate stroke as measured by the Sollerman Hand Function test and Motor Activity Log test for up to 4 years following …show more content…
Modified CIMT is defined as less intensive CIMT with reduced hours of wearing a sling on the unaffected limb as well as reduced hours of therapy. Stroke patients have been found to have a deficiency in using feedforward mechanisms such as pre-planning and executing movements from higher levels of processing; and therefore, must rely of feedback mechanism through sensory mechanisms to be able to modify and correct their ongoing movement.4 Lin et al had 32 patients with single, unilateral stroke 13-26 months from first ever stroke, indicating a “chronic” stroke. In the modified CIMT group, the unaffected hand was placed in a mitt for 6 hours during the day with rigorous training of affected limb 2 hours per weekday. Some examples of training of affected limb included stacking blocks, flipping cards, combing hair, etc. The traditional therapy group matched the same intensity of training as the modified CIMT group with strengthening, stretching, balance, and fine motor exercises. Results verified that the modified CIMT group exhibited more feedforward mechanisms with a shorter reaction time, using preplanning for reach and grasp, versus the traditional therapy group.4 Lin et al discovered that modified CIMT group was more efficient in initiating feedforward mechanisms and motor control strategy for reach to grasp activities represented by a shorter reaction

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