Article

This study compared the effects of a distributed form of
constraint-induced therapy with control intervention in motor recovery and brain
reorganization after stroke. DESIGN: A two-group randomized controlled trial with
pretreatment and posttreatment measures was conducted. Thirteen patients with
stroke were randomly assigned to the distributed form of constraint-induced
therapy (n = 5) or the control intervention group (n = 8). Outcome measures
included the Fugl-Meyer Assessment, the Motor Activity Log, and functional
magnetic resonance imaging examination. The number of activation voxels and
laterality index were determined from the functional magnetic resonance imaging
data for the study of brain reorganization. RESULTS:
The distributed form of
constraint-induced therapy group exhibited significantly greater improvements in
the Fugl-Meyer Assessment and Motor Activity Log than the control intervention
group. The functional magnetic resonance imaging data showed that distributed
form of constraint-induced therapy significantly increased activation in the
contralesional hemisphere during movement of the affected and unaffected hand.
The control intervention group showed a decrease in primary sensorimotor cortex
activation of the ipsilesional hemisphere during movement of the affected hand.
CONCLUSIONS: The preliminary findings indicate that brain adaptation may be
modulated by specific rehabilitation practices, although generalization of the
functional magnetic resonance imaging findings is limited by sample size. Further
research is needed to identify the specific neural correlates of the behavioral
gains achieved after rehabilitation therapies.

Langue : ANGLAIS