Effect of intense functional task training upon temporal structure of variability of upper extremity post stroke.

STUDY DESIGN Quasi-experimental design. INTRODUCTION Although the effectiveness of constraint-induced movement therapy (CIMT) in upper extremity (UE) rehabilitation post stroke is well known, the efficacy of CIMT to enhance the temporal structure of variability in upper extremity movement is not known. PURPOSE The purpose of this study was to investigate whether CIMT could enhance the temporal structure of variability in upper extremity movement in individuals with chronic stroke. METHODS Six participants with chronic stroke underwent CIMT for 4 h/day for 2 weeks. Participants performed three trials of functional reach-to-grasp before and after CIMT. Temporal structure of variability was determined by calculating approximate entropy (ApEn) in shoulder, elbow and wrist flexion/extension joint angles. RESULTS ApEn increased post CIMT, however, statistical significance was not achieved (p > 0.0167). CONCLUSION Future studies with larger sample size are warranted to investigate the effect of CIMT upon temporal structure of variability in UE movement. LEVEL OF EVIDENCE 4.

[1]  M. Levin,et al.  Compensatory strategies for reaching in stroke. , 2000, Brain : a journal of neurology.

[2]  T. Olsen,et al.  Arm and leg paresis as outcome predictors in stroke rehabilitation. , 1990, Stroke.

[3]  S. Holm A Simple Sequentially Rejective Multiple Test Procedure , 1979 .

[4]  J. P. Miller,et al.  Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke: the EXCITE randomized clinical trial. , 2006, JAMA.

[5]  Nicholas Stergiou,et al.  Movement Variability and the Use of Nonlinear Tools: Principles to Guide Physical Therapist Practice , 2009, Physical Therapy.

[6]  Thomas Elbert,et al.  Longer versus shorter daily constraint-induced movement therapy of chronic hemiparesis: an exploratory study. , 2002, Archives of physical medicine and rehabilitation.

[7]  Karl M. Newell More on absolute error, etc. , 1976, Journal of motor behavior.

[8]  S. Gandevia,et al.  The distribution of muscular weakness in upper motor neuron lesions affecting the arm. , 1989, Brain : a journal of neurology.

[9]  Ching-yi Wu,et al.  Effects of Modified Constraint-Induced Movement Therapy on Movement Kinematics and Daily Function in Patients With Stroke: A Kinematic Study of Motor Control Mechanisms , 2007, Neurorehabilitation and neural repair.

[10]  Albano,et al.  Filtered noise can mimic low-dimensional chaotic attractors. , 1993, Physical review. E, Statistical physics, plasmas, fluids, and related interdisciplinary topics.

[11]  M. Levin,et al.  Compensation for distal impairments of grasping in adults with hemiparesis , 2004, Experimental Brain Research.

[12]  Eliseo Stefano Maini,et al.  Using Kinematic Analysis to Evaluate Constraint-Induced Movement Therapy in Chronic Stroke Patients , 2008, Neurorehabilitation and neural repair.

[13]  L. S. Mark,et al.  Postural dynamics and the preferred critical boundary for visually guided reaching. , 1997, Journal of Experimental Psychology: Human Perception and Performance.

[14]  P. Langhorne,et al.  Motor recovery after stroke: a systematic review , 2009, The Lancet Neurology.

[15]  A. Fugl-Meyer,et al.  The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. , 1975, Scandinavian journal of rehabilitation medicine.

[16]  James Theiler,et al.  Testing for nonlinearity in time series: the method of surrogate data , 1992 .

[17]  K. Newell,et al.  Noise, information transmission, and force variability. , 1999, Journal of experimental psychology. Human perception and performance.

[18]  A. Dromerick,et al.  Does the Application of Constraint-Induced Movement Therapy During Acute Rehabilitation Reduce Arm Impairment After Ischemic Stroke? , 2000, Stroke.

[19]  S. Wolf,et al.  An application of upper-extremity constraint-induced movement therapy in a patient with subacute stroke. , 1999, Physical therapy.

[20]  E. Taub,et al.  Constraint-induced movement therapy: characterizing the intervention protocol. , 2006, Europa medicophysica.

[21]  H Rodgers,et al.  A review of the properties and limitations of the Ashworth and modified Ashworth Scales as measures of spasticity , 1999, Clinical rehabilitation.

[22]  N. Stergiou,et al.  Optimal Movement Variability: A New Theoretical Perspective for Neurologic Physical Therapy , 2006, Journal of neurologic physical therapy : JNPT.

[23]  J. H. van der Lee,et al.  Forced use of the upper extremity in chronic stroke patients: results from a single-blind randomized clinical trial. , 1999, Stroke.

[24]  L. Richards,et al.  Reliability of Upper Extremity Kinematics While Performing Different Tasks in Individuals With Stroke , 2011, Journal of motor behavior.

[25]  Michael P. Barnes,et al.  Recovery after stroke , 2005 .

[26]  Steven M. Pincus,et al.  A regularity statistic for medical data analysis , 1991, Journal of Clinical Monitoring.

[27]  N. Miller,et al.  Technique to improve chronic motor deficit after stroke. , 1993, Archives of physical medicine and rehabilitation.

[28]  D Bonaiuti,et al.  The constraint induced movement therapy: a systematic review of randomised controlled trials on the adult stroke patients. , 2007, Europa medicophysica.