Article

OBJECTIVE: To explore the effects of Mobilization and Tactile Stimulation (MTS)
and patterns of recovery in chronic stroke (>12mo) when upper limb (UL)
"performance" has reached a clear plateau. DESIGN: Replicated single-system
experimental study with 8 single cases using A-B-A design
(baseline-intervention-withdrawal phases); length of baseline randomly
determined; intervention phase involved 6 weeks of daily MTS to the
contralesional UL. SETTING: Community setting, within participants' place of
residence. PARTICIPANTS: Individual stroke survivors (N=8; male-to-female ratio,
3:1; age range, 49-76y; 4 with left hemiplegia, 4 with right hemiplegia)
discharged from ongoing therapy, more than 1 year post stroke (range, 14-48mo).
Clinical presentations were varied across the sample. INTERVENTIONS: Participants
received up to 1 hour of daily (Monday to Friday) treatment with MTS to the UL
for 6 weeks during the intervention (B) phase. MAIN OUTCOME MEASURES: Motor
function (Action Research Arm Test [ARAT]) and motor impairment (Motricity Index
[MI] arm section) of the UL. RESULTS: UL performance was stable during baseline
for all participants. On visual analysis, improvements in motor impairment were
seen in all participants, and clinically significant improvements in motor
function were seen in 4 of 8 participants during the intervention phase. Latency
between onset of intervention and improvement ranged from 5 to 31 days (ARAT) and
from 0 to 28 days (MI). Improvements in performance were maintained on withdrawal
of the intervention. Randomization tests were not significant. CONCLUSIONS: MTS
appears to improve UL motor impairment and functional activity many months, even
years, after stroke onset. Improvement can be immediate, but more often there is
latency between the start of intervention and improvement; recovery can be distal
to proximal.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS