Article

Constraint-induced therapy (CIT) is effective in improving upper
extremity motor function, but evidence is lacking about effectiveness grasp and
trunk control. This study investigated whether distributed CIT
combined with trunk restraint (dCIT + TR) benefited movement kinematics of
grasping and the trunk, as well as motor ability of the upper extremity, more
than dCIT alone. METHODS: A total of 45 stroke participants received 2 hours of
dCIT + TR, dCIT, or the dose-matched control intervention for 3 weeks. Movement
kinematics, motor ability, and daily function were the outcome measures. Movement
kinematics included grasping, joint range, and trunk movement at various phases
of reach-to-grasp tasks. Motor ability and daily function of all participants
were evaluated using the Fugl-Meyer Assessment and the Motor Activity Log.
RESULTS: Four to 5 participants in each group were not included for kinematic
analysis because of their inability to grasp a can. The dCIT + TR group showed
better preplanned grasping movement and less trunk motion at the early phase of
the reach-to-grasp movements than the dCIT or control groups. Compared with the
controls, the dCIT + TR participants showed better motor ability in the overall
and distal arm scores of the Fugl-Meyer Assessment. The dCIT + TR and dCIT
participants demonstrated significantly greater functional use of the affected
arm. CONCLUSIONS: Administering dCIT + TR produced additional benefits by
improving grasping control and reversing the compensatory trunk movement at the
early phase of a reach-to-grasp movement. The use of experimental tasks beyond
and within arm's length might improve our understanding of optimal upper
extremity rehabilitation.

Langue : ANGLAIS