學院	醫學院
系所	職能治療學系
題名	Pilot trial of distributed constraint-induced therapy with trunk restraint to improve post-stroke reach to grasp and trunk kinematics
作者	Wu, C-Y., Chen, Y-A., Chen, H-C., Lin, K-C.*, & Yeh, I-L.
期刊名稱	Neurorehabilitation and Neural Repair (SCI 期刊)
發表日期	2012
著作性質	原著
語文	英文
關鍵字	grasping, rehabilitation, kinematics, trunk restraint, constraint-induced therapy, compensatory movement, stroke
摘要	Background. Constraint-induced therapy (CIT) is effective in improving upper-extremity motor function, but evidence is lacking to show it is effective in reducing deficits in grasping control and trunk compensation. Objective. We investigated whether distributed CIT combined with trunk restraint (dCIT+TR) benefited movement kinematics of grasping and the trunk, as well as motor ability of upper-extremity, more than dCIT alone. Methods. Forty-five stroke participants received 2 hours of dCIT+TR, dCIT, or the dose-matched control intervention for 3 weeks. Movement kinematics, motor ability and daily function were the outcome measures. Movement kinematics included grasping, joint range, and trunk movement at various phases of the reach-to-grasp tasks. Motor ability and daily function of all participants were evaluated using the Fugl-Meyer Assessment (FMA) and the Motor Activity Log. Results. Four to 5 participants of each group were not included for kinematic analysis because of their inability to grasp a can. The dCIT+TR group showed better preplanned grasping movement and greater decreased trunk motion at the early phase of the reach-to-grasp movements than the dCIT or control groups. Compared with the controls, the dCIT+TR participants showed better motor ability in the overall and distal part scores of the FMA, and the dCIT+TR and dCIT participants demonstrated greater functional use of the affected arm. Conclusions. Administering dCIT+TR showed additional benefits by improving grasping control and reversing the compensatory trunk movement at the early phase of reach-to-grasp movement. The use of experimental tasks beyond and within arm’s length might improve our understanding of upper-extremity rehabilitation.