Effectiveness of Bilateral Arm Training for Improving Extremity Function and Activities of Daily Living Performance in Hemiplegic Patients.

Bilateral movement therapy, which encourages simultaneous use of the limbs on both the affected and nonaffected sides, is known to help in motor function recovery in hemiplegic patients. However, studies on the effectiveness of bilateral arm training for improving upper limb function and activities of daily living (ADL) performance in hemiplegic stroke patients are lacking. The present study investigated the effectiveness of bilateral arm training for improving upper limb function and ADL performance in hemiplegic stroke patients. The study included 30 hemiplegic stroke patients. The patients were randomly divided into an experimental group (n = 15) and a control group (n = 15). All patients received a uniform general occupational therapy session lasting 30 minutes 5 times a week for 8 weeks. The experimental group received an additional session of bilateral arm training lasting 30 minutes, and the control group received an additional session of general occupational therapy lasting 30 minutes. The Fugl-Meyer assessment (FMA), Box and Block Test (BBT), and modified Barthel index (MBI) were used for evaluation. In both the experimental and control groups, the FMA, BBT, and MBI scores were significantly higher after the intervention than before the intervention (P <.05). The changes in the FMA, BBT, and MBI scores were greater in the experimental group than in the control group (P <.05). Bilateral arm training along with general occupational therapy might be more effective than occupational therapy alone for improving upper limb function and ADL performance in hemiplegic stroke patients.

Lee MJ ，Lee JH ，Koo HM ，Lee SM ... -  《-》

The Effect of Occupation-Based Bilateral Upper Extremity Training in a Medical Setting for Stroke Patients: A Single-Blinded, Pilot Randomized Controlled Trial.

Occupation used in occupation-based intervention requires the use of 2 naturally coordinated hands. To investigate by implementing occupation-based bilateral upper extremity training in medical setting to stroke patients and determine its effect in patients' bilateral upper extremity function recovery. A total of 20 patients were randomly assigned to the experimental group (occupation-based bilateral upper extremity training) or control group (task-based bilateral upper extremity training). The intervention of the 2 groups was conducted 30 minutes a day, 5 times a week, and 4 weeks long. The outcome was assessed using the Canadian Occupational Performance Measure, Stroke Impact Scale, Action Research Arm Test, the Yonsei-Bilateral Activity Test, Accelerometer, and participants were assessed at baseline and after 4 weeks. There was a significant change in the satisfaction and performance status of occupational performance, strength, Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL), emotion, participant recovery in stroke recovery, gross movement in the function of the affected side, satisfaction in perform bilateral upper extremity in the experimental group compared to the control group. The clinical significance of this study is that this study demonstrated the effectiveness and usefulness of the training in the actual medical setting in improving upper extremity function and psychosocial factors.

Kim SH ，Park JH 《-》

Effects of robot-assisted therapy on upper extremity function and activities of daily living in hemiplegic patients: A single-blinded, randomized, controlled trial.

Lee MJ ，Lee JH ，Lee SM 《-》

Effect of Modified Constraint-Induced Movement Therapy Combined with Auditory Feedback for Trunk Control on Upper Extremity in Subacute Stroke Patients with Moderate Impairment: Randomized Controlled Pilot Trial.

The trunk compensatory strategy can impede the longer term functional recovery of the upper extremity (UE). The objective of this study is to investigate the effects of modified constraint-induced movement therapy (mCIMT) combined with auditory feedback for trunk control on UE function and activities of daily living among subacute stroke patients with moderate impairment. Twenty participants with hemiparesis were randomly assigned to either the mCIMT combined with auditory feedback group (n = 10) or the control group (n = 10). The mCIMT combined with auditory feedback group received the mCIMT protocol training at the same time as the auditory feedback for control of the compensatory movement of the trunk. The control group only received the mCIMT protocol. Each group underwent 20 (1 hour/day) intervention sessions (5 days/week for 4 weeks). The mCIMT combined with auditory feedback group exhibited greater changes in the Action Research Arm Test (P = .027; 95% CI .429-6.171), Fugl-Meyer Assessment upper extremity (P = .034; 95% CI .360-8.039), modified Barthel Index (P = .003; 95% CI 3.465-14.536), and amount of use of motor activity log (P = .009; 95% CI .078-.476) compared to the control group. There were no significant differences in the quality of movement (P = .054, 95% CI -.005 to .457) and modified Ashworth Scale (P = .288; 95% CI -.583 to .183) grades between the 2 groups. These findings suggest that mCIMT combined with auditory feedback for trunk control is more helpful in improving the UE function than mCIMT alone in subacute stroke patients with moderate impairment.

Bang DH 《-》

Combination of Exoskeletal Upper Limb Robot and Occupational Therapy Improve Activities of Daily Living Function in Acute Stroke Patients.

Previous studies have suggested that upper limb rehabilitation using therapeutic robots improves motor function of stroke patients. However, the effect of upper limb robotic rehabilitation on improving functioning in activities of daily living (ADL) remains unclear. The present study aimed to determine whether upper limb rehabilitation using single joint Hybrid Assistive Limb (HAL-SJ) affects ADL function and the use of a hemiparetic arm in ADLs of acute stroke patients. Twelve acute stroke patients participated in the study and were randomly divided into group A or group B. The patients in group A followed an A-B-A-B design and those in group B followed a B-A-B-A design. The patients received combination HAL-SJ and occupational therapy during A and conventional occupational therapy during B. Upper limb motor function and ADLs, in particular, dressing the upper body, were improved during combination HAL-SJ and occupational therapy. Interestingly, the use of a hemiparetic arm in daily life evaluated using the motor activity log was also significantly improved during A in group A. Combination HAL-SJ and occupational therapy affects ADL function and real use of a hemiparetic arm in the daily life of acute stroke patients.

Iwamoto Y ，Imura T ，Suzukawa T ，Fukuyama H ，Ishii T ，Taki S ，Imada N ，Shibukawa M ，Inagawa T ，Araki H ，Araki O ... -  《-》