Type of Article : Original Research
Year: 2015 | Volume 3 | Issue 2 | Page No. 912-918
Date of Publication: 28-02-2015
A STUDY ON THE EFFECTIVENESS OF BOBATH APPROACH VERSUS CONSTRAINT INDUCED MOVEMENT THERAPY (CIMT) TO IMPROVE THE ARM MOTOR FUNCTION AND THE HAND DEXTERITY FUNCTION IN POST STROKE PATIENTS
Bushra Rehman 1, Praveen Rawat 2, Vaibhav Agarwal * 3, Shiv Kumar Verma 3.
1Physiotherapist, Max Hospital, Dehradun, India.
2 Assistant Lecturer, Physiotherapy Department, Swami Rama Himalayan University, HIMS, Jolly Grant , Dehradun, India.
*3,4 Lecturer Physiotherapy Department Swami Rama Himalayan University, HIMS, Jolly Grant, Dehradun, India.
Corresponding author: Vaibhav Agarwal, Lecturer Physiotherapy Department Swami Rama Himalayan University, HIMS, Jolly Grant, Dehradun, India.
Objective: To compare the effects of the Bobath Therapy and Constraint-Induced Movement Therapy on arm motor function and hand dexterity function among stroke patients with a high level of function on the affected side.
Materials and Methods: Study has conducted at the Outpatient physiotherapy department of a stroke unit. With a total of 30 patients were conveniently recruited and then randomized to Bobath Concept group and constraint-induced movement therapy group. Intervention included were the Bobath Concept group was treated for 1.5 hours per day during 5 consecutive weekdays for 4 weeks whereas the constraint-induced movement therapy group received training for 2 hours per day during 5 consecutive weekdays for 3 weeks. Outcome measures by the Wolf Motor Function Test, and Jebsen Taylor Hand Function Test.
Results: The two groups were found to be homogeneous based on demographic variables and baseline measurements. There were no significant differences in Wolf Motor Function Test at post test (p = 0.861) and at follow up (p = 0.395). There is a significant improvement in JTHFT in both the groups with sight better improvement in group B (except writing components post test p=0.752and checkers at post test p=0.197 and follow up p=0.167)) as compared to Group A.
Conclusions: Bobath therapy and the Constraint-induced movement therapy have similar efficiencies in improving arm motor function in the paretic arm among stroke patients with a high level of function. Constraint-induced movement therapy seems to be slightly more efficient than the Bobath Concept in improving hand dexterity function.
KEYWORDS: Stroke, Rehabilitation, Learned Nonuse, Bobath Therapy, Upper Extremity, Arm, Dexterity Function, Gross Arm Motor Functions.
Tapas K. Banerjee and Shaymal K. Das. Epidemiology of stroke in India. Neurology Asia 2006; 11 : 1 – 4
Hilde M. Feys, Willy J. De W, Beat E. S, Gail A. Cox Steck, Ruth S, Luc E. V, Koen D. Putman and Gustaaf A,Van H. Effect of a Therapeutic Intervention for the Hemiplegic Upper Limb in the Acute Phase After Stroke : A Single-Blind, Randomized, Controlled Multicenter Trial. Stroke 1998, 29:785-792.
Wolf S, Winstein CJ, Miller JP, Taub E, Uswatte G, Morris D, Giuliani C, Light KE, Nochlos-Larsen D. Effect of Constraint-Induced Movement Therapy on Upper Extremity Function 3 to 9 Months After Stroke; The EXCITE Randomized Clinical Trial. JAMA. 2006; 296 (17): 2095-2105.
MWW Myint, KK Yu, PL Kng, CP Wong, KC Chow, CK Li, CP Wong. Use of constraint-induced movement therapy in Chinese stroke patients during the sub-acute period. Hong Kong Med J 2008;14(5):40-2.
Lin KC, Wu CY, Liu JS, Chen YT, Hsu CJ. Constraint-induced therapy versus dose-matched control intervention to improve motor ability, basic/extended daily functions, and quality of life in stroke. Neurorehabil Neural Repair. 2009 Feb;23(2):160-5.
Takashi Murayama, Kenji Numata, Takahiro Ki, Tomonari T, Masaru O4, Nobuo O, Mihoko K, Jun T.Changes in the brain activation balance in motor-related areas after constraint-induced movement therapy; a longitudinal fMRI study. 2011; 25(11):1047-1057.
Wu CY, Fu T, Lin KC, Feng CT, Hsieh KP, Yu HW, Lin CH, Hsieh CJ, Ota H. Assessing the streamlined Wolf motor function test as an outcome measure for stroke rehabilitation. Neurorehabil Neural Repair. 2011 Feb;25(2):194-9.
AnnetteS, Freivoget S.. Intensive training in chronic upper limb hemiparesis does not increase spasticity or synergies. Neurology. 2010 Dec 14;63 (11):2176-7.
Ray-Yau Wang, Chen-Yin Chen. Efficacy of Bobath versus orthopaedic approach on impairment and function at different motor recovery stages after stroke: a randomized controlled study. Clinical Rehabilitation. 2005; 19: 155-164.
Bushra Rehman, Praveen Rawat, Vaibhav Agarwal, Shiv Kumar Verma. A STUDY ON THE EFFECTIVENESS OF BOBATH APPROACH VERSUS CONSTRAINT INDUCED MOVEMENT THERAPY (CIMT) TO IMPROVE THE ARM MOTOR FUNCTION AND THE HAND DEXTERITY FUNCTION IN POST STROKE PATIENTS. Int J Physiother Res 2015;3(2):912-918. DOI: 10.16965/ijpr.2015.102