Efficacy of Modified Constraint Induced Movement Therapy Combined With Threshold Electrical Stimulation in Stroke Patients
Stroke
About this trial
This is an interventional treatment trial for Stroke focused on measuring stroke, rehabilitation, Electrical stimulation, Upper extremity
Eligibility Criteria
Inclusion Criteria:
- Stroke patients aged between 18-80 years
- Having had a stroke at least 3 months and at most 24 months ago
- Having an active range of motion of the upper extremity which is stated below:
Shoulder flexion and abduction of at least 45 degrees Starting from a 90° flexion position, at least 20° elbow extension Starting from full of wrist flexion position at least 20° wrist extension At least 10° of extension at the metacarpophalangeal and interphalangeal joints of all fingers
- Absence of severe spasticity to affect the treatment (spasticity in any joint of the upper extremity ≤2 according to the Modified Ashworth Scale)
Exclusion Criteria:
- Uncontrollable arrhythmia and/or hypertension
- Presence of advanced sensory deficit
- Visual and hearing problems
- Presence of severe spasticity to affect the treatment (spasticity in any joint of the upper extremity >2 according to the Modified Ashworth Scale)
Sites / Locations
- Emel Mete
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
No Intervention
Experimental group-1 (M-CIMT group)
Experimental group-2 (M-CIMT+TES group)
Control group
participants in this group will be trained with Modified Constraint Induced Therapy (M-CIMT) in addition to conventional therapy. M-CIMT is shorter versions of CIMT. The original CIMT devotes six or more hours for therapy and constraining of the intact arm for 90% of waking hours per day and over a period of two weeks. Researchers have observed that such a schedule of CIMT is exhaustive and possibly resulting in non-compliance. Because of this reason,s Modified shorter versions of CIMT (mCIMT) have been designed by researchers. Duration of M-CIMT interventions varies from 2 to 10 weeks and the treatment time also varies from as short as 30 minutes to three hours per day in various studies. Nevertheless both CIMT and mCIMT have shown promising success. M-CIMT emphasizes massed practice with the affected upper limb.
participants in this group will be trained with Modified Constraint Induced Therapy (M-CIMT) and threshold electrical stimulation (TES) in addition to conventional therapy. TES is based on low-intensity (<100 Hz) and long-duration current and is applied with superficial electrodes. TES provides a natural proprioception by depolarizing the sensory and motor nerves without causing any muscle contraction. TES can improve motor learning and motor performance by improving connections between sensory-motor cortical association regions in the brain.
participants in this group will be trained with conventional therapy. Conventional therapy consists of strength training, stretching exercises and functional activity training.