Effectiveness Of Combined Rehabilitation Intervention For Upper Limb Function In Chronic Stroke

Abstract

Introduction: Reducing disability and improving upper limb function after stroke often involve several different interventions and require the co-operation of the patient and rehabilitation team. Goal: To determine whether the combination of rehabilitation (physical/aquatic therapy – PT/AT) and occupational therapy (OT) yielded better results in the treatment of chronic stroke sequelae than physical/ aquatic therapy intervention concurrent with electrical stimulation. Materials and methods: The study included 42 poststroke hemiplegic patients undergoing treatment at the “Sf. Maria” Neuromotor Rehabilitation Centre, Craiova, and was conducted between November 2016 and December 2017. The subjects were randomly distributed into two groups: group 1 consisted of 21 patients who underwent physical/aquatic therapy plus OT, and group 2 consisted of 21 patients who underwent physical/aquatic therapy plus electrical stimulation. The functional status of hemiplegic patients was evaluated by applying the Rivermead Test, and their motor function (upper extremity) was evaluated by using the Fugl-Meyer Test. Results: Both types of intervention showed statistically higher functional change scores. Rivermead and Fugl-Meyer scores were higher (p = 0.01) for subjects who received PT/AT and OT versus patients only receiving PT and TENS (Transcutaneous Electrical Nerve Stimulation). Conclusion: We found an improvement in the upperlimb functional state of our patients with chronic stroke after combination of physical/aquatic therapy and occupational therapy. The application of this treatment combination proved to be more effective in restoring the function of the affected arm, inducing clinically meaningful functional improvement compared to the application of PT/AT therapy and TENS. © 2019 Published by Future Academy www.FutureAcademy.org.UK