Tyrėjai E.Taub, S.Wolf, S.Page ir kt. pasiūlė daug žadantį treniravimo būdą, kuris pagerina paveiktos rankos judesius po insulto. Terapija vadinama „Judesių suvaržymo terapija“ (JST, angl. Constraint–induced movement therapy). Tyrimo hipotezė – manome, kad judesių suvaržymo terapijos taikymas ūmiu laikotarpiu po galvos smegenų insulto yra efektyvesnis metodas, siekiant atgauti paveiktos rankos funkciją, nei įprastų fizinių pratimų taikymas. Tyrimo tikslas – įvertinti judesių suvaržymo terapijos poveikį atgaunant paveiktos rankos judesius ūmiu laikotarpiu po galvos smegenų insulto. Tyrimo uždaviniai: 1. Nustatyti ligonių, sergančių galvos smegenų insultu, paveiktos rankos funkciją prieš ir po įprastų fizinių pratimų taikymo. 2. Ištirti ligonių, sergančių galvos smegenų insultu, paveiktos rankos funkciją prieš ir po judesių suvaržymo terapijos. 3. Palyginti judesių suvaržymo terapijos ir fizinių pratimų poveikį paveiktos rankos funkcijos atgavimui. Tyrimas buvo atliktas VŠĮ Šiaulių apskrities ligoninėje, neurologijos skyriuje, 2006-2007m. Tyrime dalyvavo 30 pacientų: 16 vyrų ir 14 moterų, sergančių galvos smegenų insultu. Tiriamieji suskirstyti į dvi grupes. Tiriamajai grupei buvo taikyta judesių suvaržymo terapija. Taikant šią terapiją, sveikos rankos judesiai suvaržomi specialia rankos pirštine. Šią pirštinę ligoniai turėjo mūvėti 6 valandas per dieną ne miego... [toliau žr. visą tekstą] / E.Taub, S.Wolf, S.Page and other researchers lately presented fast-track exercise method that improves impacted hand’s movements after stroke. This is a “constraint-induced movement therapy”(CIMT). Key words: constraint-induced movement therapy, impacted hand, stroke, acute period. Hypothesis of this study: we think that in recovery of impacted hand function the application of CIMT in acute period after stroke is more effective method than application of common physical exercises. Purpose of this study: to evaluate the effect of the CIMT to the impacted hand movements in acute period after stroke. Goals of this study: To evaluate impacted hand function before and after application of physical exercises for the subjects who had strokes. To evaluate impacted hand function before and after application of CIMT for the subjects who had strokes. To compare the effect of CIMT and physical exercises for recovery of impacted hand function. This study took place in neurological department of Siauliai hospital in 2006-2007. 30 subjects who had stroke participated in this study: 16 men and 14 women. The subjects were assigned in two groups. Control group subjects received CIMT. Applying this therapy not impaired hand’s movements are inhibited with a special glove. Subjects had to wear this glove 6 hours a day except the sleep time. Every hour they had breaks for 10 minutes. The treatment course lasted 10 days. There was an agreement about cases when the subject could take of the... [to full text]

Constraint induced movement therapy is one of many neurorehabilitation methods, based on principle of overcoming the learned non-use phenomenon by a specific therapeutic protocol including some behavioral techniques. A classification of currently available studies on the topic have been made on the model of literature review, with an in-depth focus on using Constraint induced movement therapy in occupational therapy for adult patients after stroke who have upper limb motor disorders. The present study is structured into two sections: a theoretical part and an analytic-descriptive one. In theoretical part history of the method is presented together at Basic method principles and detail contents of a therapeutic protocol. The analytical and descriptive section is aimed to analyse international studies important and relevant with respect to an occupational therapy practice. In this second section are also proposed many possible activities of shaping and task practice techniques which can be used by occupational therapists. Translation of the most widely used test (Motor Activity Log and Wolf Motor Function Test) into Czech language is included. Keywords: constraint induced movement therapy, stroke, upper extremity, occupational therapy

Syfte: Syftet med studien var att beskriva arbetsterapeuters erfarenheter av att använda sig av CI-terapi som intervention för barn med hemiplegisk cerebral pares. Metod: En kvalitativ ansats valdes för att beskriva arbetsterapeuternas subjektiva upplevelser. Åtta semistrukturerade intervjuer genomfördes med arbetsterapeuter som arbetade på barn- och ungdomshabiliteringar i landet och analyserades därefter utifrån kvalitativ innehållsanalys. Resultat: Den insamlade datan resulterade i fyra kategorier: Arbetsterapeutens stöd; Nätverkets betydelse; Anpassning av interventionen samt Organisatoriska strukturer. Resultatet visade att interventionen bör utgå från barnets motivation och lek i samverkan med barnets nätverk samt att interventionen mestadels bidrog till att barnet fick en utökad aktivitetsrepertoar. Vidare beskrevs att interventionen utfördes endast av några arbetsterapeuter runt om i landet då den är tidskrävande, kräver resurser och en tydlig struktur. Det framkom även att kollegialt stöd bland arbetsterapeuterna främjar genomförandet av CI-terapi. Slutsats: I studien framkommer att barnets aktivitetsrepertoar mestadels förbättrades med CI-terapi men kunde inte påvisas med nuvarande bedömningsinstrument. / Purpose: The aim of this study was to describe occupational therapists’ experience of using Constraint Induced Movement Therapy for children with hemiplegic cerebral palsy. Methods: A qualitative method was chosen to describe the subjective experiences of the occupational therapists. Eight semi structured interviews were conducted with occupational therapists that were working at different centres for child and adolescent rehabilitation in this country, thereafter the collected data was analysed using qualitative content analysis. Result: The results were divided into four categories: The occupational therapist’s support, The importance of the network, Adaptation of the intervention and The organisational structures. The result indicate that the intervention should be centred on the child’s motivation and play in collaboration with the child’s social network and the intervention usually leads to an extended activity repertoire for the child. Furthermore, the result indicates the intervention to be time consuming, demanding extensive structure and resources, which led to the intervention was performed by only a few occupational therapists. It also appeared that collegial support among occupational therapists promotes the implementation of Constraint Induced Movement Therapy. Conclusion: The study show that the child’s range of activities often were improved when using Constraint Induced Movement Therapy, but this could not be proven with today’s assessment instrument.

Made available in DSpace on 2015-07-22T20:49:20Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-07-30 / Introdução: A Terapia por Contensão Induzida (TCI) ou Constraint-induced Movement Therapy é uma intervenção que tem como objetivo a recuperação do membro superior afetado de pacientes hemiparéticos devido à lesão encefálica. É aplicada através de um tratamento intensivo durante duas semanas consecutivas, com seis horas diárias de exercícios e uso de uma tipóia, durante 90% do dia, no membro superior não-afetado. O ganho motor da TCI é validado através das escalas funcionais de avaliação do membro superior (EFAMS) Wolf Motor Function Test (WMFT) e Action Research Arm Test (ARAT). Objetivo: Realizar uma análise comparativa entre ambas as EFAMS. Métodos: As EFAMS foram aplicadas em quatro períodos distintos em 17 pacientes com o diagnóstico de acidente vascular cerebral isquêmico, que realizaram individualmente a TCI durante duas semanas com seis horas diárias de exercícios e após foi feito uma análise comparativa entre as EFAMS em relação ao tempo de aplicação, tempo de preparação da mesa, reprodutibilidade e análise fatorial. Resultados: Diminuição no escore da EFAMS WMFT e aumento no escore da EFAMS ARAT pós TCI, não houve variação significativa dos escores entre os períodos pré e pós TCI das EFAMS, diminuição do tempo de preparação da mesa e aplicação de ambas as EFAMS pós TCI e a análise fatorial detectou dois e três componentes qualitativos na EFAMS ARAT e WMFT, respectivamente. Conclusões: Ambas as EFAMS conseguem mensurar o ganho motor da TCI, com alta reprodutibilidade, sendo que o tempo de aplicação e preparação da mesa é menor na EFAMS ARAT e somente a EFAMS WMFT apresenta o componente qualitativo “lateralidade”. / The Constraint-induced Movement therapy (CIMT) is an intervention which main goal is the recuperation of affected upper extremity in hemiparetic patients with acquired encephalic lesion. Its protocol consists by an intensive treatment of two consecutive weeks with six hours of exercises and the wear of arm sling in non affected upper arm during 90% of daily activities. The motor improvement of CIMT is validity by the functional evaluation scales of upper extremity (FESUE) Wolf Motor Function Test (WMFT) and Action Research Arm Test (ARAT). Objective: Realize a comparative analysis between both scales. Methodology: The FESUE had been applied during four different times in 17 patients with diagnosis of ischemic stroke, who made individually the CIMT during two weeks and six hours of exercises and after made a comparative analysis between the FESUE by time for application, time for preparation of the table, reproducibility and factorial analysis. Results: Decreased in score of FESUE WMFT and increased in score of FESUE ARAT after CIMT, no significant variation in the score between before and after CIMT of the FESUE, decreased in time to preparation the table and application of FESUE in both scales and the factorial analysis showed two and three qualitative components in FESUE ARAT and WMFT, respectively. Conclusions: Both FESUE can measure the therapeutics gains of CIMT, with high reproducibility, but the time for application and preparation of the table are minor in FESUE ARAT and only the FESUE WMFT shows the qualitative component “laterality”. / TEDE / BV UNIFESP: Teses e dissertações

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