Effects of constraint-induced movement therapy for lower limbs on measurements of functional mobility and postural balance in subjects with stroke: a randomized controlled trial

• Published in: Topics in stroke rehabilitation Vol. 24; no. 8; p. 555
• Main Authors: E Silva, Emília Márcia Gomes de Souza, Ribeiro, Tatiana Souza, da Silva, Tállyta Camyla Chaves, Costa, Mayara Fabiana Pereira, Cavalcanti, Fabrícia Azevedo da Costa, Lindquist, Ana Raquel Rodrigues
• Format: Journal Article
• Language: English
• Published: England 01.12.2017
• Subjects: Aged; Biomechanical Phenomena; Exercise Test; Exercise Therapy; Female; Humans; Lower Extremity - physiopathology; Male; Middle Aged; Physical Therapy Modalities; Postural Balance; Single-Blind Method; Stroke - physiopathology; Stroke Rehabilitation - methods; Walking; rehabilitation; physical restraint; gait; Lower extremity paresis; kinematics; clinical trials; physical therapy
• DOI: 10.1080/10749357.2017.1366011

Abstrato Background: Constraint-induced movement therapy (CIMT) is suggested to reduce functional asymmetry between the upper limbs after stroke. However, there are few studies about CIMT for lower limbs. To examine the effects of CIMT for lower limbs on functional mobility and postural balance in subjects with stroke. A 40-day follow-up, single-blind randomized controlled trial was performed with 38 subacute stroke patients (mean of 4.5 months post-stroke). Participants were randomized into: treadmill training with load to restraint the non-paretic ankle (experimental group) or treadmill training without load (control group). Both groups performing daily training for two consecutive weeks (nine sessions) and performed home-based exercises during this period. As outcome measures, postural balance (Berg Balance Scale - BBS) and functional mobility (Timed Up and Go test - TUG and kinematic parameters of turning - Qualisys System of movement analysis) were obtained at baseline, mid-training, post-training and follow-up. Repeated-measures ANOVA showed improvements after training in postural balance (BBS: F = 39.39, P < .001) and functional mobility, showed by TUG (F = 18.33, P < .001) and by kinematic turning parameters (turn speed: F = 35.13, P < .001; stride length: F = 29.71, P < .001; stride time: F = 13.42, P < .001). All these improvements were observed in both groups and maintained in follow-up. These results suggest that two weeks of treadmill gait training associated to home-based exercises can be effective to improve postural balance and functional mobility in subacute stroke patients. However, the load addition was not a differential factor in intervention.