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The effect of “constraint induced movement therapy” on velocity and gait kinetics in hemiparetic patients

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Author(s): M Shaikh | F Bahrpeyma | E Ebrahimi Takamajani | B Forough

Journal: Razi Journal of Medical Sciences
ISSN 2228-7043

Volume: 17;
Issue: 78;
Start page: 34;
Date: 2010;
Original page

Keywords: Gait | Kinetics | Movement therapy | Hemiparesis

ABSTRACT
  Introduction: Balance and gait disorders are common motor complications after stroke. Studies have revealed that conventional physiotherapy cannot manage these disorders efficiently; so more studies addressing the causes of these complications and presenting efficient treatment protocols are crucial.   Methods: Thirty hemiparetic patients (age range 40-60 years old) participated in this experimental study. Patients were randomly divided in to 2 groups. One group received Constraint Induced Movement Therapy (CIMT) (group1) and the other Mass Practice (group 2) for 3 weeks. Experimental assessments included stride velocity and kinetic parameters of gait (amplitude and velocity of center of pressure sways of paretic and non-paretic limbs in sagittal and frontal planes) that were recorded and compared before and after treatment. For statistical analysis of data, if distribution of data was normal, parametric tests of t and pair t-tests were used. If distribution of data was not normal, non parametric tests of Wilcoxon and Mann-Whitney were used. SPSS V.11.5 was also used for data analysis.   Results: In both groups, stride velocity increased (p=0.03, p=0.01). In CIMT group, COP sway for paretic and non-paretic limbs decreased in frontal plane (p=0.03, p=0.008). COP sway velocity for paretic limb decreased in both planes (p=0.01, p=0.03). For mass practice group, only COP sway amplitude for non-paretic limb decreased in sagittal plane (p=0.03).   Conclusion: Physical therapy based on “Constraint Induced Movement Therapy” can more efficiently manage dynamic balance gait disorders by overcoming "learned non-use" phenomena and improving somato-sensory deafferentation to central motor controllers.

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Tangokurs Rapperswil-Jona

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