Compare constraint-induced movement therapy and bobath to improve hand functions in hemiplegic patients

Abstract

Introduction: With changes in techniques to treat hand functions in hemiplegic patients, both Constraint-Induced Movement Therapy (CIMT) where an unaffected hand is restrained from its use & Bobath where an unaffected hand is unrestrained are proved to be beneficial individually. Objcetive: To compare both & to implement the better one for a speedy recovery. Methods: Participants aged above 50, with Brainstorm stage of hand 2 and above were randomly divided into CIMT(n=10) and Bobath (n=10), the treatment being given for 30 min/day for the first 2 weeks, then 3 times/week for consecutive 10 weeks. Bobath includes Affected side weight-bearing, Bilateral Activity encouragement, Auto inhibition, Active wrist extension emphasizing MCP flexion, thumb abduction, Active finger extension by sweep tapping forearm dorsum, by withdrawing bottle brush from hand, transferring various shaped objects from sound to affected hand, Power grasps followed by prehension and repetition of tasks. CIMT includes the same as above but restraining the affected upper limb with a sling is worn 3 hours priorly avoiding bilateral activity. Fugl Meyer Assessment is used to measure hand functions, Functional Independence Measure (FIM) scale is used to measure ADL. Results: Paired t-test showed an improvement, Independent t showed a difference in improvement between 2 groups. Percentage of difference between pretest (day1), posttest (day 60) showed increased improvement in hand functions and ADL in CIMT than Bobath. Conclusion: Previous studies show CIMT & Bobath to be successful. The results of this study show CIMT is superior to Bobath in improving hand functions in Hemiplegics.