Shanta Pandian1, Kamal Narayan Arya2, E W Rajkumar Davidson1. 1. Pt. Deendayal Upadhyaya Institute for the Physically Handicapped (University of Delhi), Ministry of Social Justice & Empowerment, Govt. of India, New Delhi-110002, India. 2. Pt. Deendayal Upadhyaya Institute for the Physically Handicapped (University of Delhi), Ministry of Social Justice & Empowerment, Govt. of India, New Delhi-110002, India. Electronic address: kamalnarya@yahoo.com.
Abstract
BACKGROUND: Motor recovery of the hand usually plateaus in chronic stroke patients. Various conventional and contemporary approaches have been used to rehabilitate the hand post-stroke. However, the evidence for their effectiveness is still limited. OBJECTIVE: To compare the hand therapy protocols based on Brunnstrom approach and motor relearning program in rehabilitation of the hand of chronic stroke patients. DESIGN: Randomized trial. SETTING:Outpatients attending the occupational therapy department of a rehabilitation institute. SUBJECTS:30 post-stroke subjects (35.06 ± 14.52 months) were randomly assigned into two equal groups (Group A and Group B), Outcome Measures: Brunnstrom recovery stages of hand (BRS-H), Fugl-Meyer assessment: wrist and hand (FMA-WH). INTERVENTION: Group A received Brunnstrom hand manipulation (BHM). BHM is the hand treatment protocol of the Brunnstrom movement therapy, which uses synergies and reflexes to develop voluntary motor control. Group B received the Motor Relearning Program (MRP) based hand protocol. MRP is the practice of specific motor skills, which results in the ability to perform a task. Active practice of context-specific motor task such as reaching and grasping helps regain the lost motor functions. RESULTS: Both the therapy protocols were effective in rehabilitation of the hand (BRS-H; p = 0.003 to 0.004, FMA-WH; p < 0.001). However, the results were statistically significant in favor of group A undergoing BHM for FMA-WH (p < 0.004) and FMA item VIII (hand motor recovery) (p < 0.033). CONCLUSION:BHM was found to be more effective than MRP in rehabilitation of the hand in chronic post-stroke patients.
RCT Entities:
BACKGROUND: Motor recovery of the hand usually plateaus in chronic strokepatients. Various conventional and contemporary approaches have been used to rehabilitate the hand post-stroke. However, the evidence for their effectiveness is still limited. OBJECTIVE: To compare the hand therapy protocols based on Brunnstrom approach and motor relearning program in rehabilitation of the hand of chronic strokepatients. DESIGN: Randomized trial. SETTING: Outpatients attending the occupational therapy department of a rehabilitation institute. SUBJECTS: 30 post-stroke subjects (35.06 ± 14.52 months) were randomly assigned into two equal groups (Group A and Group B), Outcome Measures: Brunnstrom recovery stages of hand (BRS-H), Fugl-Meyer assessment: wrist and hand (FMA-WH). INTERVENTION: Group A received Brunnstrom hand manipulation (BHM). BHM is the hand treatment protocol of the Brunnstrom movement therapy, which uses synergies and reflexes to develop voluntary motor control. Group B received the Motor Relearning Program (MRP) based hand protocol. MRP is the practice of specific motor skills, which results in the ability to perform a task. Active practice of context-specific motor task such as reaching and grasping helps regain the lost motor functions. RESULTS: Both the therapy protocols were effective in rehabilitation of the hand (BRS-H; p = 0.003 to 0.004, FMA-WH; p < 0.001). However, the results were statistically significant in favor of group A undergoing BHM for FMA-WH (p < 0.004) and FMA item VIII (hand motor recovery) (p < 0.033). CONCLUSION: BHM was found to be more effective than MRP in rehabilitation of the hand in chronic post-strokepatients.
Authors: Lianne Brkic; Lisa Shaw; Frederike van Wijck; Richard Francis; Christopher Price; Anne Forster; Peter Langhorne; Caroline Watkins; Helen Rodgers Journal: Pilot Feasibility Stud Date: 2016-08-17