The effect of group physiotherapy on functional motor dexterity and upper limb strength in chronic hemiparetic patients
DOI:
https://doi.org/10.33233/fb.v21i2.3101Keywords:
circuit-based training, paresis, motor skills, muscle strengthAbstract
Introduction: Stroke is the cause of several neurological disabilities in adults, which makes it necessary to better study the impact on functional capacity. Objective: The objective was to evaluate the motor dexterity performance of upper limbs in chronic hemiparetic submitted to Group Physiotherapy in the Training Circuit (GPTC) format, as this form of treatment has been shown to be effective in the improvement functional capacity, which makes it necessary a study aimed at the upper limb. Methods: Fifteen hemiparetic patients in our service with GPTC participated. An initial assessment (IA1) was performed using the Modified Ashworth scale, Box and Block Test (BBT), and the 9-Hole Peg Test (9-HPT). After 12 weeks of intervention with GPTC, the final evaluation (FE2) was performed using the same tests. Results: Statistical analysis considered p > 0.05 and did not reveal a significant difference between IA1 and FE2 in hand-held dynamometry as well as in the BBT and 9-HPT. Conclusion: The therapeutic protocol did not determine the improvement of the motor dexterity of upper limbs in chronic hemiparetic patients submitted to GPTC.
References
Pollock A, Farmer SE, Brady MC, Langhorne P, Mead GE, Mehrholz J et al. Interventions for improving upper limb function after stroke. Cochrane Database Syst Rev 2014;11(11). doi: 10.1002/14651858.CD010820.pub2
French B, Thomas LH, Leathley MJ, Sutton CJ, McAdam J, Forster A, et al. Repetitive task training for improving functional ability after stroke BT - Cochrane Database Syst Rev Cochrane Database Syst Rev 2016;(11). doi: 10.1002/14651858.CD006073.pub3
Brito RG, Lins LCRF, Almeida CDA, Neto ESR, Araújo DP, Franco CIF. Instrumentos de avaliação funcional específicos para o acidente vascular cerebral. Rev Neurociencias 2013;21(4):593-9. doi: 10.4181/RNC.2013.21.850.7p
Chen HM, Chen CC, Hsueh IP, Huang SL, Hsieh CL. Test-retest reproducibility and smallest real difference of 5 hand function tests in patients with stroke. Neurorehabil Neural Repair 2009;23(5):435-40. doi: 10.1177/1545968308331146
Dean CM, Richards CL, Malouin F. Task-related circuit training improves performance of locomotor tasks in chronic stroke: A randomized, controlled pilot trial. Arch Phys Med Rehabil 2000;81(4):409-17. doi: 10.1053/mr.2000.3839
Corbetta D, Sirtori V, Castellini G, Moja L, Gatti R. Constraint-induced movement therapy for upper extremities in people with stroke (review). Cochrane Database Syst Rev 2015;(10):1-117. doi: 10.1002/14651858.CD004433.pub3
Winter J, Hunter S, Sim J, Crome P. Hands-on therapy interventions for upper limb motor dysfunction following stroke (Review). Cochrane Database Syst Rev 2011;(6).
Bashir S, Caipa A, Plow EB. Assessment of behavioral tasks performed by hemiplegic patients with impaired dexterity post stroke. Eur Rev Med Pharmacol Sci 2017;21(10):2443-51.
Pang MY, Harris JE, Eng JJ. A community-based upper-extremity group exercise program improves motor function and performance of functional activities in chronic stroke: A randomized controlled trial. Arch Phys Med Rehabil 2006;87(1):1-9. doi: 10.1016/j.apmr.2005.08.113
Lang CE. Reduced muscle selectivity during individuated finger movements in humans after damage to the motor cortex or corticospinal tract. J Neurophysiol 2004;91(4):1722-33. doi: 10.1152/jn.00805.2003
McCombe Waller S, Whitall J. Fine motor control in adults with and without chronic hemiparesis: Baseline comparison to nondisabled adults and effects of bilateral arm training. Arch Phys Med Rehabil 2004;85(7):1076–83. doi: 10.1016/j.apmr.2003.10.020
Rode G, Rossetti Y, Boisson D. Inverse relationship between sensation of effort and muscular force during recovery from pure motor hemiplegia: A single-case study. Neuropsychologia 1996;34(2):87-95. doi: 10.1016/0028-3932(95)00065-8
Rossini PM, Calautti C, Pauri F, Baron JC. Post-stroke plastic reorganisation in the adult brain. Lancet Neurol 2003;2(8):493–502. doi: 10.1016/S1474-4422(03)00485-X
Feys H, Hetebrij J, Wilms G, Dom R, De Weerdt W. Predicting arm recovery following stroke: Value of site of lesion. Acta Neurol Scand 2000;102(6):371-7. doi: 10.1034/j.1600-0404.2000.102006371.x
Kwakkel G, Kollen BJ, Van der Grond JV, Prevo AJH. Probability of regaining dexterity in the flaccid upper limb: Impact of severity of paresis and time since onset in acute stroke. Stroke 2003;34(9):2181-6.
Canning CG, Ada L, Adams R, O´Dwyer NJ. Loss of strength contributes more to physical disability after stroke than loss of dexterity. Clin Rehabil 2004;18(3):300-8. doi: 10.1191/0269215504cr715oa
Fuscaldi Teixeira-Salmela L, Santos E, Oliveira G, Geralda E, Santana S, Resende GP. Fortalecimento muscular e condicionamento físico em hemiplégicos. Acta Fisiátr 2000;7(72):67-73. doi: 10.5935/0104-7795.20000001
English C, Hillier S. Circuit class therapy for improving mobility after stroke: A systematic review. J Rehabil Med 2011;43(7):565-71. doi: 10.1002/14651858.CD007513.pub3
English CK, Hillier SL, Stiller KR, Warden-Flood A. Circuit class therapy versus individual physiotherapy sessions during inpatient stroke rehabilitation: a controlled trial. Arch Phys Med Rehabil 2007;88(8):955-63. doi: 10.1016/j.apmr.2007.04.010
Gregson JM, Leathley M, Moore AP, Sharma AK, Smith TL, Watkins CL. Reliability of the tone assessment scale and the modified Ashworth scale as clinical tools for assessing poststroke spasticity. Arch Phys Med Rehabil 1999;80(9):1013-6. doi: 10.1016/s0003-9993(99)90053-9
Figueiredo IM, Sampaio RF, Mancini MC, Silva F, Souza MA. Teste de força de preensão utilizando o dinamômetro Jamar. Acta Fisiátr 2007;14:104-10. doi: 10.5935/0104-7795.20070002
Guimarães R, Blascovi-Assis SM. Uso do teste caixa e blocos na avaliação de destreza manual em crianças e jovens com Síndrome de Down. Rev Ter Ocup Univ São Paulo 2012;23:98-106. doi: 10.11606/issn.2238-6149.v23i1p98-106
Beebe JA, Lang CE. Relationships and responsiveness of six upper extremity function tests during the first 6 months of recovery after stroke. J Neurol Phys Ther 2009;33(2):96-103. doi: 10.1097/NPT.0b013e3181a33638
Mathiowetz V, Weber K, Kashman N, Volland G. Adult norms for the Nine Hole Peg Test of finger dexterity. Occup Ther J Res 1985;5(1):24-38. doi: 10.1177/153944928500500102
Grice KO, Vogel KA, Le V, Mitchell A, Muniz S, Vollmer MA. Adult norms for a commercially available nine hole peg test for finger dexterity. Am J Occup Ther 2003;57(5):570-3. doi: 10.5014/ajot.57.5.570
Ekstrand E, Lexell J, Brogårdh C. Test-retest reliability and convergent validity of three manual dexterity measures in persons with chronic stroke. PMR 2015;8:935-43. doi: 10.1016/j.pmrj.2016.02.014
Soares AV, Kerscher C, Uhlig L, Domenech SC, Júnior NGB. Dinamometria de preensão manual como parâmetro de avaliação funcional do membro superior de pacientes hemiparéticos por acidente vascular cerebral Handgrip dynamometry as a parameter of functional evaluation of the upper extremity hemiparetic after stroke. Fisioter Pesqui 2011;18(4):359-64. doi: 10.1590/S1809-29502011000400011
Bonini-Rocha AC, Andrade ALS, Moraes AM, Gomide Matheus LB, Diniz LR, Martins WR. (2018). Effectiveness of circuit-based exercises on gait speed, balance, and functional mobility in people affected by stroke: a meta-analysis. PM&R 2018;10(4):398-409. doi: 10.1016/j.pmrj.2017.09.014
Loureiro LMJ, Gameiro MGH. Interpretação crítica dos resultados estatísticos: para lá da significância estatística. Rev Enferm Ref 2011;3(3):151-62.
Published
Issue
Section
License
Copyright (c) 2020 Isabella Cristina Leoci, Katiane Mayara Guerrero, Andressa Sampaio Pereira, Larissa Borba André, Mileide Cristina Stoco de Oliveira, Carla de Oliveira Carletti, Caroline Nunes Gonzaga, Silas de Oliveira Damasceno, Alice Haniuda Moliterno, Isabela Bortolim Frasson, Nicoly Ribeiro Uliam, Guilherme Yassuyuki Tacao, Lúcia Martins Barbatto, Augusto Cesinando de Carvalho
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors are authorized for non-exclusive distribution of the version of the work published in this journal (eg, publishing in an institutional repository or as a book chapter), with acknowledgment of authorship and initial publication in this journal.