Effects of Bilateral Passive Range of Motion Exercise on the Function of
Upper Extremities and Activities of Daily Living in Patients with Acute
Stroke

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Abstract

[Purpose] To evaluate the effects of early passive range of motion exercise on the function of upper extremities and activities of daily living in patients with acute stroke. [Methods] A total of 37 patients with acute stroke in intensive care units, were assigned to the experimental group (n=19) and control group (n=18). The experimental group performed passive range of motion exercise twice a day, for 4 weeks, immediately after a pretest; the patients in the control group performed the range of motion exercise in the same manner for 2 weeks beginning 2 weeks after the pretest. The functions of upper extremities (edema, range of motion), manual function, and activities of daily living of both groups were measured before and at four weeks after the intervention. [Results] The experimental group showed a significant decrease in the edema of upper extremities compared with the control group. It also showed a significant increase in the range of motion, function of upper extremities, and the activities of daily living compared to the control group. [Conclusion] Passive range of motion exercise in the early stage can improve the function of upper extremities and activities of daily living in patients with acute stroke.

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Most cited references 7

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Toward wisdom from failure: lessons from neuroprotective stroke trials and new therapeutic directions.

M. Hakim, , D Gladstone … (2002)

Neuroprotective drugs for acute stroke have appeared to work in animals, only to fail when tested in humans. With the failure of so many clinical trials, the future of neuroprotective drug development is in jeopardy. Current hypotheses and methodologies must continue to be reevaluated, and new strategies need to be explored. Summary of Review- In part 1, we review key challenges and complexities in translational stroke research by focusing on the "disconnect" in the way that neuroprotective agents have traditionally been assessed in clinical trials compared with animal models. In preclinical studies, determination of neuroprotection has relied heavily on assessment of infarct volume measurements (instead of functional outcomes), short-term (instead of long-term) end points, transient (instead of permanent) ischemia models, short (instead of extended) time windows for drug administration, and protection of cerebral gray matter (instead of both gray and white matter). Clinical trials have often been limited by inappropriately long time windows, insufficient statistical power, insensitive outcome measures, inclusion of protocol violators, failure to target specific stroke subtypes, and failure to target the ischemic penumbra. In part 2, we explore new concepts in ischemic pathophysiology that should encourage us also to think beyond the hyperacute phase of ischemia and consider the design of trials that use multiagent therapy and exploit the capacity of the brain for neuroplasticity and repair. By recognizing the strengths and limitations of animal models of stroke and the shortcomings of previous clinical trials, we hope to move translational research forward for the development of new therapies for the acute and subacute stages after stroke.

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Constraint-induced movement therapy during early stroke rehabilitation.

Corwin Boake, Elizabeth Noser, Tony Ro … (2015)

Limited data are available about the effectiveness of early rehabilitation after stroke. This is the 1st randomized controlled trial of constraint-induced movement therapy (CIMT) in subacute stroke to investigate neurophysiologic mechanisms and long-term outcome. Within 2 weeks after stroke, 23 patients with upper extremity (UE) weakness were randomized to 2 weeks of CIMT or traditional therapy at an equal frequency of up to 3 h/day. Motor function of the affected UE was blindly assessed before treatment, after treatment, and 3 months after stroke. Transcranial magnetic stimulation (TMS) measured the cortical area evoking movement of the affected hand. Long-term improvement in motor function of the affected UE did not differ significantly between patients who received CIMT versus intensive traditional therapy. All outcome comparisons showed trends favoring CIMT over intensive traditional therapy, but none was statistically significant except for improvements in the Fugl-Meyer (FM) UE motor scale immediately following treatment and in reported quality of hand function at 3 months. Improvement in UE motor function on the FM was associated with a greater number of sites on the affected cerebral hemisphere where responses of the affected hand were evoked by TMS. Future trials of CIMT during early stroke rehabilitation need greater statistical power, more inclusive eligibility criteria, and improved experimental control over treatment intensity. The relationship between changes in motor function and in evoked motor responses suggests that motor recovery during the 1st 3 months after stroke is associated with increased motor excitability of the affected cerebral hemisphere.

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Functional assessment scales: a study of persons with multiple sclerosis.

C V Granger, A Cotter, B Hamilton … (1990)

The purpose of this study was to investigate disability in persons with multiple sclerosis (MS) by using combinations of functional assessment scales and subscales to predict (1) the burden of care measured in minutes of assistance provided per day by another person in the home, and (2) the subject's level of satisfaction with life in general. The Functional Independence Measure (FIM), Incapacity Status Scale, Environmental Status Scale, and the Barthel Index had high intercorrelations with each other. Although each was predictive of the MS subject's physical care needs, the FIM was the most useful. A change in total FIM score of one point was equivalent to an average of 3.38 minutes of help from another person per day. With the Brief Symptom Inventory and the Environmental Status Scale, the FIM contributed to predicting the patient's general satisfaction as well. We propose that burden of care and subjective satisfaction with life be the standards by which functional assessment instruments are compared to reflect, in pragmatic terms, the impact of disability on the lives of individuals and on the human and economic resources of the community.

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Author and article information

Journal

Journal ID (nlm-ta): J Phys Ther Sci

Journal ID (iso-abbrev): J Phys Ther Sci

Journal ID (publisher-id): JPTS

Title: Journal of Physical Therapy Science

Publisher: The Society of Physical Therapy Science

ISSN (Print): 0915-5287

ISSN (Electronic): 2187-5626

Publication date (Electronic): 06 February 2014

Publication date (Print): January 2014

Volume: 26

Issue: 1

Pages: 149-156

Affiliations

[1) ] College of Nursing, Pusan Catholic University, Pusan, Republic of Korea

[2) ] School of Nursing, University of Pennsylvania, USA

[3) ] College of Nursing, The Catholic University of Korea, Republic of Korea

Author notes

[* ]Corresponding author. Kyeong-Yae Sohng, College of Nursing, The Catholic University of Korea: 505 Banpo-dong, Socho-gu, Seoul 137-701, Republic of Korea. (e-mail: sky@ 123456catholic.ac.kr )

Article

Publisher ID: jpts-2013-323

DOI: 10.1589/jpts.26.149

PMC ID: 3927029

SO-VID: ca454222-1f57-4009-bdf7-9ab8c2cf889a

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (by-nc-nd) License.

Effects of Bilateral Passive Range of Motion Exercise on the Function of Upper Extremities and Activities of Daily Living in Patients with Acute Stroke

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Abstract

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Stroke MRI

Most cited references 7

Toward wisdom from failure: lessons from neuroprotective stroke trials and new therapeutic directions.

Constraint-induced movement therapy during early stroke rehabilitation.

Functional assessment scales: a study of persons with multiple sclerosis.

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