Improvement of the functional recovery of the upper limb in hemiplegic patients by the use of the technique of induced stress therapy

Year 2020, , 292 - 299, 04.07.2020

Teddy Bofosa , Eric Kam , Betty Miangindula Constant Nkiama Tharcisse Kayembe

https://doi.org/10.18621/eurj.499045

Abstract

Objectives: To investigate the effects of the induced stress therapy technique in functional recovery of the upper limb in hemiplegic patients.

Methods: We conducted a longitudinal study that consisted in following the evolution of the functional recovery of the upper limbs of 60 hemiplegic subjects of the center for physical disabilities of Kinshasa subjected to a program of induced stress therapy for a period of six months from April 2018 to October 2018. The Fugl Meyer scale and Action Research Arm test allowed us to see the effects of this treatment. The parametric t test of student allowed us to compare the averages before and after the treatment.

Results: After 6 months of the study, the results of our cases showed a very significant difference between the mean values of global motor skills scores at Action Research Arm between the beginning (51 ± 21%) and the end of treatment (64 ± 20%; p < 0.05). The difference in mean values at the Fugl Meyer scale was also very significant, both at overall scores and under-scores (p < 0.05). There is a very significant difference between older and younger patients compared to the mean values of their overall scores on the motor and independence scales (p < 0.05).

Conclusions: We found that induced stress therapy significantly improved the level of functional recovery and autonomy at the Action Research Arm and Fugl Meyer scales. In addition, this improvement was a little slower in the hand than in the other segments of the upper limb. 

Keywords

induced stress therapy, functional recovery, hemiplegic, upper limb

References

• 1. Bossa D. Guide pratique en cas d’hémiplégie, vignot édition, Paris, 1999: p. 255.
• 2. Person M. La rééducation de la préhension après un accident vasculaire cérébral: l’apport des nouvelles techniques. Kinesither Scient 2009;505:32-9. [Article in French]
• 3. Picard Y. Evaluation clinique de la motricité d’une personne adulte atteinte d’hémiplégie. Motricité cérébrale 2003;24:81-107.
• 4. Blanchard M. Vade-mecum de médecine pratique, 8ème édition, Masson et Cie, Paris, 2002: p. 277.
• 5. Bofosa T, Kam E, Njimbu F, Mpefi P, Kayembe T, Miagindula B, Impact of a program of induced stress therapy on the motor and functional recovery of the upper limb of hemiplegic patients in Kinshasa, Democratic Republic of Congo. J Surg Med 2018;2:339-43.
• 6. Kam E, Bofosa T, Lempira F, Malemba A, Nkongo H, Nkiama C, et al. Impact of lack of rehabilitation follow-up care on the functional level and autonomy of vascular hemiplegic patients at Kinshasa University clinics on homecoming. Med Sci Discovery 2018;5:274-78.
• 7. Recommandations de bonne pratique Accident vasculaire cérébral: Prise en charge précoce (alerte, phase pré hospitalière, phase hospitalière initiale, indications de la thrombolyse) HAS 2009.
• 8. Fery-Lemonniere E. Prévention et prise en charge des accidents vasculaires cérébraux en France, Rapport présentés au Ministère de la Santé et des Sports, ISRN SAN-DHOS/RE-09-2-FR, Juin 2009.
• 9. Wolf SL, Winstein CJ, Miller JP, Taub E, Uswatte G, Morris D, et al. Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke. The EXCITE randomized clinical trial. JAMA 2006,296:2095-104.
• 10. Daviet JC. Facteurs prédictifs du devenir vital et fonctionnel d’une cohorte d’hémiplégiques vasculaires. Conséquences sur les modalités de prise en charge, Thèse, Faculté de Médecine, Université Limoges; 2004.
• 11. Tshianga H. Trajectoires de services de réadaptation post-AVC Un continuum centré sur la personne, Rapport du Comité d’experts sur l’offre de services de réadaptation post-AVC Présidé par Carol L. Richards, O.C., Québec 2013.
• 12. Langhorne P, Coupar F, Pollock A. Motor recovery after stroke: a systematic review. Lancet Neurol 2009;8:741-54.
• 13. Carlsson CM, Stein JH. Cardiovascular diseases and the aging woman: overcoming barriers to lifestyle changes. Curr Womens Health Rep 2002;2:366-72.
• 14. Robinson RG. Poststroke depression: prevalence, diagnosis, treatment, and disease progression. Biol Psychiatry 2003;54:376-87.
• 15. Tshianga H. Impact des troubles cognitifs sur la récupération fonctionnelle et l’autonomie des patients en post AVC, Mémoire, Faculté de Médecine, Université de Kinshasa, Juin 2018.
• 16. Petit H. [What is the impact of initial prognosis factors on the efficacy and indications of rehabilitation following stroke?] Ann Readapt Med Phys 1997;40:113-20. [Article in French]
• 17. Meijer R, Ihnenfeldt DS, Van Limbeek J, Vermeulen M, Haan RJ. Prognostic factors for ambulation and activities of daily living in the subacute phase after stroke. A systematic review of the literature. Clin Rehabil 2003;17:119-29.
• 18. Feigenson JS, McCarthy ML, Greenberg SD, Feigenson WD. Factors influencing outcome and length of stay in a stroke rehabilitation unit. Part 2. Comparison of 318 screened and 248 unscreened patients. Stroke 1977; 8:651-62.
• 19. Granger CV, Hamilton BB, Fiedler RC. Discharge outcome after stroke rehabilitation. Stroke 1992;23:978-82.