Effect of Task Oriented Training on Spasticity in Post Stroke Individuals
Purpose: Post-stroke spasticity may be maladaptive and interfere with an individual’s ability to perform functionally useful movement. However studies investigating how the spasticity relates to motor recovery are rare. Reducing the limb spasticity will help post stroke individuals function better at the activities of daily living. There is a paucity of literature showing the effect of task oriented approach on spasticity when compared to the standard conventional approach. Hence, there is a need to find out the effect of task oriented training on spasticity in post stroke individuals. Methods: A comparative study with a study design of Randomised Clinical Trial (RCT) was conducted among 60 post stroke individuals (30 post stroke individuals in group A and Group B respectively). Group A was given a task oriented approach for managing the spasticity and group B was given conventional treatment along with a task oriented approach to manage the spasticity. The treatment protocol for both the groups lasted for 6 weeks (4 days a week). Results: The mean and standard deviation on the Modified Ashworth Scale of Group A and Group B at baseline is 3.46 ± 0.68 and 3.56 ± 0.72 respectively which shows no significance (p value = 0.2925 and t value = 0.5493). The mean and standard deviation of Group A and Group B at 6 weeks is 2.4 ± 1.04 and 1.33 ± 1.1 respectively which is significant (p value = 0.0003, t value = 3.877.) Conclusion: It can be concluded that task oriented training alone is effective in acute stroke survivors, but in chronic stroke survivors it is not remarkably efficacious and requires a combined approach of task oriented training along with conventional management for finer outcomes.
- Moon JH, Park KY, Kim HJ, Na CH. The effects of task-oriented circuit training using rehabilitation tools on the upper-extremity functions and daily activities of patients with acute stroke: A randomized controlled pilot trial. Osong Public Health and Research Perspectives. 2018 Oct; 9(5):225. PMid: 30402377 PMCid: PMC6202022. https://doi.org/10.24171/j.phrp.2018.9.5.03
- Kuberan P, Kumar V, Joshua AM, Misri ZK, Chakrapani M. Effects of task oriented exercises with altered sensory input on balance and functional mobility in chronic stroke: A pilot randomized controlled trial. Bangladesh Journal of Medical Science. 2017 Mar 23; 16(2):307–13. https://doi.org/10.3329/bjms.v16i2.24953
- McDonnell MN, Hillier SL, Miles TS, Thompson PD, Ridding MC. Influence of combined afferent stimulation and task-specific training following stroke: A pilot randomized controlled trial. Neurorehabilitation and Neural Repair. 2007 Sep; 21(5):435–43. PMid: 17405883. https://doi.org/10.1177/1545968307300437
- Rekand T. Clinical assessment and management of spasticity: A review. Acta Neurologica Scandinavica. 2010 Jul; 122:62–6. PMid: 20586738. https://doi.org/10.1111/j.1600-0404.2010.01378.x
- Timmermans AA, Spooren AI, Kingma H, Seelen HA. Influence of task-oriented training content on skilled arm-hand performance in stroke: A systematic review. Neurorehabilitation and Neural Repair. 2010 Nov; 24(9):858–70. PMid: 20921325. https:// doi.org/10.1177/1545968310368963
- Frimpong E, Olawale OA, Antwi DA, Antwi-Boasiako C, Dzudzor B. Task-oriented circuit training improves ambulatory functions in acute stroke: A randomized controlled trial. Journal of Medicine and Medical Sciences. 2014; 5(8):169–75.
- Kumar RT, Pandyan AD, Sharma AK. Biomechanical measurement of post-stroke spasticity. Age and ageing. 2006 Jul 1; 35(4):371–5. PMid: 16675479. https://doi.org/10.1093/ageing/ afj084
- Plantin J, Pennati GV, Roca P, Baron JC, Laurencikas E, Weber K, Godbolt AK, Borg J, Lindberg PG. Quantitative assessment of hand spasticity after stroke: Imaging correlates and impact on motor recovery. Frontiers in Neurology. 2019 Aug 12; 10:836. PMid: 31456734 PMCid: PMC6699580. https://doi.org/10.3389/ fneur.2019.00836
- O’Sullivan SB, Schmitz TJ, Fulk G. Physical Rehabilitation. F A Davis; 2019 Jan 25.
- Shah S, Vanclay F, Cooper B. Improving the sensitivity of the Barthel Index for stroke rehabilitation. Journal of Clinical Epidemiology. 1989; 42:703–9. https://doi.org/10.1016/08954356(89)90065-6
- Shah S, Cooper B. Documentation for measuring stroke rehabilitation outcomes. Australian Medical Records Journal. 1991; 21:88–95. https://doi.org/10.1177/183335839102100304
- Shaw LC, Price CI, van Wijck FM, Shackley P, Steen N, Barnes MP, Ford GA, Graham LA, Rodgers H. Botulinum Toxin for the Upper Limb after Stroke (BoTULS) Trial: Effect on impairment, activity limitation and pain. Stroke. 2011 May; 42(5):1371–9. PMid: 21415398. https://doi.org/10.1161/STROKEAHA.110.582197
- Ghandehari K, Ghandehari K, Saffarian-Toosi G, Masoudinezhad S, Yazdani S, Nooraddin A, Ebrahimzadeh S, Ahmadi F, Abrishamchi F. Comparative interrater reliability of Asian Stroke Disability Scale, modified Rankin Scale and Barthel Index in patients with brain infarction. ARYA Atherosclerosis. 2012; 8(3):153.
- Winstein CJ, Wolf SL, Dromerick AW, Lane CJ, Nelsen MA, Lewthwaite R, Cen SY, Azen SP. Effect of a task-oriented rehabilitation program on upper extremity recovery following motor stroke: the ICARE randomized clinical trial. Jama. 2016 Feb 9; 315(6):571–81. PMid: 26864411 PMCid: PMC4795962. https://doi.org/10.1001/jama.2016.0276
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