Case Study Of CIMT

Most exercise is designed for neurorehabilitation, not cardiovascular health, so there is a very different definition for stroke patient exercise, as well as a very different goal set. Because strokes affect each person differently, treatment is also specific to the individual. The literature included in this review focuses on three different methods of exercise, each with very specific goals in mind. Cabanas-Valdés and collegues study was on Core and Trunk stability, Minyoung describes use of Virtual Reality enhanced exercise for treatment, and Tutak introduces the concepts behind Rehabilitation

Stroke is a leading health care problem worldwide; ‘living with stroke’ is a real challenge both stroke survivors and their caregivers face.

Hanger, H. C., Wills, K. L., & Wilkinson, T. (2014). Classification of falls in stroke rehabilitation - not all falls are the same. Clinical Rehabilitation, 28(2), 183-95. doi:http://dx.doi.org.southuniversity.libproxy.edmc.edu/10.1177/0269215513496801

The purpose of this study was to identify the effect that mental practice would have on learning a sequential task for the lower limb. This was a single case study regarding an individual with a hemiparesis from a stroke. The study took place in a research laboratory of a university-affiliated rehabilitation center. The participant was a 38-year-old man who had suffered a left hemorrhagic subcortical stroke four months prior to the experiment (Jackson, Doyon, Richards, & Malouin, 2004). The subject was required to practice a serial response time task with the lower limb in three distinct training phases over a period of five weeks: two weeks of physical practice, one week of combined physical and mental practice, and then two weeks of mental practice alone (Jackson et al., 2004). The main outcome measure included the Kinesthetic and Visual Imagery Questionnaire (KVIQ). The KVIQ includes a series of 10 gestures and is adapted for older patients and patients with motor deficits. In this assessment, the patients rate their ability to elicit mental images of the action on two 5-point scales (5 = high imagery; 1 = low imagery). One scale rates the clarity of the image, and the other rates the intensity at which they can feel themselves performing the movement. Utilizing physical practice alone, the patient’s average response time did improve during the first five days, but then failed to show further improvement during the remaining days of physical practice. The combination of mental and physical practice yielded additional improvement; whereas, the following two weeks of mental practice alone resulted in minimal improvement in performance (Jackson et al., 2004). The findings from this case-study showed that when mental and physical practices are combined,

Like the first article above, the purpose of this study was to determine the efficacy of mental practice use on upper-extremity impairment and functional outcomes on stroke patients, but also to see if mental practice plus physical practice would yield better results. This study took place in a licensed university-affiliated rehabilitation hospital. The design of this experiment was a case study, which consisted of only four total participants. Participants were chosen randomly; three men and one woman with moderate upper-limb hemiparesis post-stroke. Two subjects received mental practice and constraint-induced movement therapy (CIMT), one subject received only mental practice, and one received only CIMT. The main outcomes measures were the Wolf Motor Function Test (WMFT) and the Motor Activity Log (MAL). The WMFT is a validated test that measures time (15 tasks) or strength (2 tasks) in completing upper-extremity joint specific or multiple joint movements or functions. The MAL is an upper-extremity disability measure. It is a semi-structured interview during which participants are asked to rate how much and how well (6-point scale; range, 0 worst to 5 best) they use their more affected arm for 30 ADL items in the home environment over a specified period. The participant who received only mental practice showed slight

(2013). The efficacy of SMART Arm training early after stroke for stroke survivors with severe upper limb disability: a protocol for a randomized controlled trial. BMC Neurol 2; 13:71.

Physical therapists working at these large hospitals throughout the Midwest where recruitment will occur will be formally trained how on how to perform MT so that therapists will be consistent within and between patients. Both groups will receive 1 hour of MT of the upper extremity 5 days a week for 4 weeks. In addition to this treatment, the physical therapist will also work with patients in both groups on limb activation for 1 hour 5 days a week for 4 weeks and provide the more traditional physical therapy given to stroke patients, such as doing exercises to improve strength in the upper and lower extremity on the affected side involving neuromuscular re-education, pre-walking functional activities, weight shifts in sitting or standing, or the maintenance of unassisted

In the initial stage of stroke, the patient still had antigravity muscle power of the left upper and lower limbs. Therefore, the decision for early supported discharge once patient was able to self-propel the wheelchair with both his hands and was mildly dependent for activities of daily living (ADLs) was deemed justifiable. Early supported discharge has been shown to improve overall cost by reducing the length of inpatient hospitalization, reducing risk of death or institutionalization as well as improving instrumental activities of daily of living (iADL)(2). However, once the stroke evolved leading to dense flaccidity of the left upper limb, his latest condition should be communicated back to the

The second article chosen is a case study aptly named “Playing Piano Can Improve Upper Extremity Function after Stroke: Case Studies”. The article’s philosophical approach was to find a method for stroke patients to implement rehabilitation in an engaging

My research addresses rehabilitation post-stroke, primarily improving lower extremity function. I study factors contributing to compensation, which involves greater than normal use of the non-impaired limb compared to the impaired limb. Compensation can be detrimental to rehabilitation as the impaired limb is underutilized and function cannot be restored. This may lead to weakness and impaired mobility/gait.

support early intervention of cognitive rehabilitation of having a great effect on improving ADL participation in stroke patient. The first article from Cochrane library titled “Cognitive rehabilitation for executive dysfunction in adults with stroke or other adult non-progressive acquired brain damage” by Charlie et al discuss which adaptive technique was used to assist stroke survivors who have cognitive impairment, but intact motor function to became independent in the ADL. The research was completed on “19 studies of 907 randomized participants, 496 TBI, 344 strokes, 67 other acquired brain injury. Data were available to potentially include 13 of the studies within meta-analyses (770 participants, 417 TBI, 304 stroke, 49 other acquired brain injury), with 660 participants who are related to the research were included in the treatment groups to be studied in the review. Studies performed during the research were related to (1) cognitive rehabilitation versus sensorimotor meta-analyses (one study, 86 participants), (2) cognitive rehabilitation versus no intervention or placebo meta-analyses (four studies, 184 participants) and (3) experimental cognitive rehabilitation versus standard cognitive rehabilitation meta-analyses (eight studies, 404 participants)”

People often relate the loss of arm mobility to stroke patients because it is so noticeable when a person cannot use one of their arms properly. Statistics show, “motor deficits are common following stroke. Approximately 43% to 69% of people suffering from a stroke have upper-extremity impairment, 1, 2 and 4 years after a stroke, 67% still experience non-use of the affected arm as a major problem” (Siebers et al., 389). In these cases, CIMT can be more beneficial than less invasive therapies. CIMT looks to force movement and use of the affected side of the body after a stroke in order to promote rehabilitation while limiting the unaffected limb. However, this type of therapy does not come easily as CIMT is a very rigorous therapy. In the article, Stroke patients ' and therapists ' opinions of constraint-induced movement therapy, it was stated this therapy is intense because the unaffected arm is restrained while the patient participates in about 6 hours

Constraint Induced Movement Therapy (CIMT) is a treatment approach that has been found to be effective in unilateral (hemiplegic) spastic cerebral palsy. It involves constraint of the less impaired upper extremity and repetitive practice of the affected arm and hand. Casts, splints, and slings are used to restrain the unaffected arm while the individual is encouraged to use the impaired arm. The individual performs motor activities repetitively for up to 6 hours a day for 2 to 4 weeks. In order to perform more complex functional motor acts, the task is broken down into smaller movements and rewarded at each step of the

The subjects of the study were ten people who had recently had a stroke, two were women and eight were men. Additionally, these people had only one leg affected and were able to safely use all the testing equipment. Each person was first subject to four tests for a clinical assessment to better understand the subjects. These tests were the Modified Ashworth Scale, Timed Up and Go Test, manual muscle testing, and a test to determine the person’s range of motion.

Hemiplegia is defined as the complete loss of movement or sensation to an entire half of the body. Hemiparesis is a partial loss of sensation or movement throughout one side of the body. Both hemiplegia and hemiparesis are common after a person has had a severe stroke. According to the Center for Disease Control “Stroke is the fifth leading cause of death in the United States and is a major cause of adult disability. About 800,000 people in the United States have a stroke each year” (Stroke Statistics, 2015). A stroke occurs when a blood vessel bursts and oxygen is not being transported to the brain properly. The Stroke Center, a leading independent information provider on strokes, states, “Stroke is the leading cause of serious, long term