Exploring a repetitive training regime for upper limb hemiparesis in an in-patient setting: a report on three case studies.

PRIMARY

OBJECTIVE

To explore the efficacy of a task-oriented repetitive training protocol (RTx) in chronic hemiparetic patients in an in-patient rehabilitation unit.

RESEARCH

DESIGN

Three case studies; ABAB design (A=RTx; B=regular rehabilitation programme; 1 week per phase, respectively) in case P1, pre-post intervention comparison in case P2; repeated measure design in case P3.

METHODS AND PROCEDURES: Daily training of task-oriented affected hand movements using shaping procedures developed in Constraint-Induced (CI) Movement Therapy. Patients 1 and 2 were trained daily for 90 minutes over 2 weeks. Patient 3 received 60 minutes of daily training for a period of 4 weeks. Outcome measures were Wolf Motor Function Test (WMFT), Frenchay Arm Test, nine-hole peg test, upper extremity MRC, and grip force.

MAIN OUTCOMES AND

RESULTS

Substantial clinical benefits were achieved in all patients. The subjective observations mirrored significant improvements in the outcome parameters.

CONCLUSION

The affected hand training improves upper limb motor functions in chronic patients. It is a 'practicable' approach for in-patient rehabilitation units.