Inmeli Hastalarda Modifiye Kısıtlayarak – Zorlayıcı Hareket Tedavisinin Alt Ekstremite Fonksiyonları, Denge, Ambulasyon ve Yaşam Kalitesi Üzerine Etkileri

Abstract

The purpose of this study was to compare the effects of neurophysiological based exercise approach (control group) and modified constraint induced movement therapy (experimental group) in stroke patients. Thirty patients with stroke, who were 18 or above ages and had stroke first, brunnstrom lower extremity staging ≥3, functional ambulation classification ≥2, 3-12 months were passed after stroke, without any additional physical or neurological problem included into this study. Patients were divided into two groups according to randomization method. The exercises, which were based on neurophysiological approach applied to both groups during first 4 weeks, 3 days a week, 1 hour a day and than during the next 2 weeks, 5 days a week, 2 hours a day, modified constraint induced movement therapy was applied to patients in experimental group and exercises, which were based on neurophysiological approach was performed to patients in control group. Functional mobility, spatiotemporal parameters of gait, gait speed, postural symmetry and symmetry of weight bearing, motor function, the amount of improvement perceived by patients and quality of life were evaluated three times such as pre-treatment, in fourth week and post-treatment. As a result of the study, between at fourth week and at sixth week evaluations post-treatment were difference in the walking speed, the cadence, the non-affected side step length, the affected side foot angle, step symmetry, the functional balance, postural and weight bearing symmetry, the recovery amount and the quality of life increased more in the experimental group (p<0,05). The improvement of the motor function was much more between pre-treatment and post-treatment evaluations in the experimental group (p<0,05). Between pre-treatment and in fourth week evaluations were not different in all measurements. The functional mobility, the affected side step length, non-afected side foot angle, stride length, step width measurements were similar for groups between in fouth week and post-teratment evaluations (p>0,05). As a result, modified constraint induced movement therapy had enhancing effects on lower extremity function, balance, ambulation and quality of life in patients with stroke. Modified constraint induced movement therapy could be used as an new alternative treatment for lower extremity in the stroke rehabilitation.