The effect of Task-oriented training versus Progressive resistance training on Upper limb function and Quality of life in Stroke subjects- A Randomized Clinical Trial.

The comparison of the effect of Task-oriented training and Progressive resistance training in stroke subjects

Authors

  • Priyanka singh sikkim manipal university
  • Nitesh chettri chowan sikkim manipal university

Keywords:

Task oriented training, Quality of life, Stroke, Upper extremity, Resistance training

Abstract

Background and Objectives:

Task-oriented training (TOT) and Progressive resistance training (PRE) are two techniques which has proved its effectiveness in treatment of stroke subjects.  The majority of evidence focuses on chronic stroke and supports TOT use at this stage of recovery. Although the studies are fewer in number, the evidence also supports TOT as an effective intervention for the UE post stroke in the sub acute stage of recovery. Previous literature has also suggested for its comparison and best can be recommended for clinical practice. So, the aim of this study is to compare the effect of TOT and PRE on upper extremity motor recovery and functional status in sub acute stroke subjects.

 

Materials and methods:

Total of 40 stroke subjects who is having minimal motor criterion and met other inclusion criteria were recruited from department of physiotherapy, central referral hospital. Subjects were randomized into two group i.e. TOT (Group A) and PRE (Group B). Pre and post intervention outcome measures were taken using Action research arm test, Box and Block test, Fugl‑Meyer assessment, overall functional status by Modified Barthel index and Quality of life by Stroke Specific Quality of life questionnaire.

 

Result:

At baseline subjects of both group showed no significant differences regarding ARAT, BBT, FMA, MBI and SS-QOL scores but after 3 weeks of intervention, subjects of both group showed statistically significant improvements in all the variables measured (p<0∙05). There was significant improvement in TOT group compared to the PRE group.

 

Conclusion:

The present study confirms that TOT is an effective treatment technique to improve upper extremity motor recovery, hand and finger dexterity, functional status and quality of life in stroke subjects compare to PRE. It is cost effective, easy and safe method for rehabilitation and most important can be easily administered at home by the subjects. Overall, clinicians will consider their stroke subjects stage of recovery and TOT to implement for their particular practice setting, in the context of the evidence supporting.

References

1. Ralph L. Sacco et al. An Updated Definition of Stroke for the 21st Century. A Statement for Healthcare Professionals from the American Heart Association/American Stroke Association. Stroke. 2013; 44:2064-2089.
2. Cleusa P Ferri Claudia Schoenborn, Lalit Kalra, Daisy Acosta, Mariella Guerra, Yueqin Huang,K S Jacob et al. Prevalence of stroke and related burden among older people living in Latin America, India and China. J Neurol Neurosurg Psychiatry 2011; 82:1074-1082.
3. Catherine Donaldson, Raymond Tallis, FmedSci, Simon Miller, Alan Sunderland, Roger Lemon, and Valerie Pomeroy. Effects of Conventional Physical Therapy and Functional Strength Training on Upper Limb Motor Recovery after Stroke: A Randomized Phase II Study. Neurorehabil Neural Repair. 2009 May; 23(4):389-97.
4. Gui Bin Song. The effect of task-oriented versus repetitive bilateral arm training on upper limb function and activities of daily living in stroke patients. J. phys. Ther,sci, 2015;27:1353-1355.
5. Chanuk Yoo et al, Impact of task -oriented training on hand function and activities of daily living after stroke. J. Phys .Ther. Sci 2015; 27: 2529-2531.
6. Gergory T. Thielman et al, Rehabilitation of Reaching After Stroke: Task-Related Training Versus Progressive Resistive Exercise Arch Phys Med Rehabil 2004;85:1613-8.
7. Flansbjer, Ulla-Britt; Lexell, Jan Brogårdh, Christina. Long-Term Benefits of Progressive Resistance Training in Chronic Stroke: A 4-year Follow-Up. : Journal of Rehabilitation Medicine, 44( 3), March 2012;.218-221.
8. Pollock A, Farmer SE, Brady MC, et al.: Interventions for improving upper limb function after stroke. Cochrane Database Syst Rev, 2014, (11): CD010820.
9. Catherine Donaldson, Raymond Tallis, FmedSci, Simon Miller, Alan Sunderland, Roger Lemon, and Valerie Pomeroy. Effects of Conventional Physical Therapy and Functional Strength Training on Upper Limb Motor Recovery after Stroke: A Randomized Phase II Study. Neurorehabil Neural Repair. 2009 May;23(4):389-97.
10. Gemperline JJ, Allen S, Walk D, et al. Characteristics of motor unit discharge in subjects with hemi paresis. Muscle Nerve. 1995;18(10):1101–14.
11. Bourbonnais, D, Vanden Noven, S. Weakness in patients with hemiparesis. American Journal of Occupational Therapy. 1989;43:313–319.
12. Hara Y, Masakado Y, Chino N. The physiological functional loss of single thenar motor units in the stroke patients: when does it occur? Does it progress? Clinical Neurophysiology. 2004; 115 (1):97–103.
13. Langhorne P, Coupar F, Pollock A. Motor recovery after stroke: a systematic review. Lancet Neurology 2009;8(8): 741–54.
14. Morrissey, MC, Harman, EA, Johnson, MJ. Resistance training modes: specificity and effectiveness. Med Sci Sports Exerc. 1995;27:648–660.
15. Hankey GJ, Warlow CP. Treatment and secondary prevention of stroke: evidence, costs, and effects on individuals and populations. Lancet 1999; 354: 457‐1463.
16. Linda S. Williams, Morris Weinberger, Lisa E. Harris, Daniel O. Clark and José Biller. Development of a Stroke-Specific Quality of Life Scale. Stroke. 1999;30: 1362-1369.
17. Saunders DH, Greig CA, Mead GE, Young A. Physical fitness training for stroke subjects. Cochrane Database of Systematic Reviews 2009, Issue 4. Art. No.: CD003316.
18. Flansbjer, Ulla-Britt; Lexell, Jan Brogårdh, Christina. Long-Term Benefits of Progressive Resistance Training in Chronic Stroke: A 4-year Follow-Up. : Journal of Rehabilitation Medicine, March 2012; 44( 3), 200-206.
19. Pollock A, Farmer SE, Brady MC, Langhorne P, Mead GE, Mehrholz J, van Wijck F. Interventions for improving upper limb function after stroke. Cochrane Database of Systematic Reviews 2014, Issue 11. Art. No.: CD010820.
20. Felipe Jos´e Aidar, Ricardo Jac´o de Oliveira, Ant´onio Jos´e Silva, Dihogo Gama de Matos,Mauro L´ucio Mazini Filho, Robert C. Hickner, and Victor Machado Reis, The Influence of Resistance Exercise Training on the Levels of Anxiety in Ischemic Stroke. Stroke Research and Treatment Volume 2012, 6.
21. Ming-De Chen, MS, OT; James H. Rimmer, PhD .Effects of Exercise on Quality of Life in Stroke Survivors. A Meta-Analysis. Stroke. 2011;42: 832-837.
22. Kleim JA, Jones TA: Principles of experience-dependent neural plasticity: implications for rehabilitation after brain damage. J Speech Lang Hear Res, 2008,51: S225–S239.
23. Goodwill AM, Pearce AJ, Kidgell DJ. Corticomotor plasticity following unilateral strength training. Muscle Nerve.2012; 46:384–93.
24. Kidgell DJ, Stokes MA, Pearce AJ. Strength training of one limb increases cor-ticomotor excitability projecting to the contralateral homologous limb. Motor Control. 2011; 15:247–66.
25. Nijland, Rinske; van Wegen, Erwin; Verbunt, Jeanine; van Wijk, Renske; van Kordelaar, Joost; Kwakkel, Gert A comparison of two validated tests for upper limb function after stroke: The Wolf Motor Function Test and the Action Research Arm Test. Source: Journal of Rehabilitation Medicine, 2010; 42:7: 694-696(3).
26. Julie Sanford, Julie Moreland, Laurie R Swanson, Paul W and Carolyn gowland. Motor Performance in Subjects Following Stroke. Reliability of the Fugl-Meyer Assessment for Testing Motor Performance in Subjects Following Stroke. Phy the. 1993;73:447-454.
27. Platz T, Pinkowski C, van Wijck F, Kim I-H, di Bella P, Johnson G. Reliability and validity of arm function assessment with standardized guidelines for the Fugl-Meyer Test, Action Research Arm Test and Box and Block Test: a multicentre study. ClinRehabil. 2005;19(4):404–11.
28. Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J. 1965; 14: 61-5.
29. Linda S. Williams, Morris Weinberger, Lisa E. Harris, Daniel O. Clark and José Biller. Development of a Stroke-Specific Quality of Life Scale. Stroke. 1999;30:1362-1369.
30. Jannette Blennerhasset and Wayne Dite.Additional task-related practice improves mobility and upper limb function early after stroke. A randomized control trial. Aust journal of physiotherapy.2004;50:219-224.
31. Jackie Bosch et al.Does task-oriented practice improve UE motor recovery after stroke?A Systematic review. Hindawai publishing corporation ISRN stroke.2014; 504910:10.
32. Ming-De Chen, James H. Rimmer. Effects of Exercise on Quality of life in Stroke Survivors. A Meta-Analysis.Stroke.2011;42:832-837.
33. Kamen G and CA Knight. Training related adaptation in motor unit discharge rate in young and old adults. J Gerontology.2004;59:1334-38.
34. Gabriel DA et al. Neural adaptation to resistive exercise: mechanism and recommendation for training practices.2006;36:133-49.
35. Signal NEJet al. Strength training after stroke: Rationale, evidence and potential implementation barriers for physiotherapy. New Zeland journal of physiotherapy.2011; 42:101-107.
36. Yaa-Ru Yang et al. Task oriented progressive resistance strength training improves muscle strength and functional performance in individual with Stroke. Single blinded randomized controlled trial. Journal of clinical rehabilitation.2006;20:860-70.
37. Hen et al. Repetitive training of isolated movements improves the outcome of rehabilitation of the centrally paretic hand. J Neurolsci.1995;130:59-68.
38. Susan L Morris et al. Outcome of progressive resistance strength training following Stroke. A Systematic review. Clinical Rehabilitation.2004;18:27-39.
39. Kim CM, Eng JJ, MacIntyre DL, Dawson AS. Effects of isokinetic strength training on walking in persons with stroke: a double-blind controlled pilot study. Journal of Stroke and Cerebrovascular Diseases 2001;10(6):265–73.

Downloads

Published

2019-11-28

How to Cite

singh, P., & chowan, N. chettri. (2019). The effect of Task-oriented training versus Progressive resistance training on Upper limb function and Quality of life in Stroke subjects- A Randomized Clinical Trial.: The comparison of the effect of Task-oriented training and Progressive resistance training in stroke subjects. National Journal of Integrated Research in Medicine, 10(5), 19–27. Retrieved from http://nicpd.ac.in/ojs-/index.php/njirm/article/view/2584

Issue

Section

Original Articles