Resources search

Constraint - Induced Movement Therapy: Determinants and Correlates of Duration of Adherence to Restraint use Among Stroke Survivors with Hemiparesis

OLASUNKANMI, D O
OLASUMBO, S A
2012

Expand view

Background: Constraint-Induced Movement Therapy (CIMT) was developed to improve purposeful movement of the stroke-affected extremity by restricting the use of the unaffected extremity. The two main components of CIMT are the training of the more-impaired arm to perform functional tasks, and the restraint of the less-impaired arm. One challenge that the application of CIMT faces is in ensuring adherence to the use of restraint.

 

Purpose: There is a need to determine the factors that may influence adherence, as this would allow CIMT to be delivered more effectively, and prevent situations where unrealistic expectations are placed on stroke–affected individuals.

 

Methods: Thirty stroke survivors with hemiparesis who met the inclusion criteria were consecutively recruited from the physiotherapy out-patient clinics, using a purposive sampling technique. A structured questionnaire was used to obtain information on clinical and socio-demographic parameters. The participants were given a restraint and an adherence time log-book, to make a daily record during the period they wore the restraint. The adherence time log- book was collected at the end of every week of the 3-week study. Motor function and functional use of the upper limb were measured using Motricity Index and Motor Activity Log respectively. Data was analysed using mean and standard deviations, independent t-test and Spearman rho; p was significant at 0.05.

 

Results: Gender (p=0.73) and side affected/handedness (p=0.79) had no significant influence on the percentage duration of adherence to restraint use (DARU). The influence of socio-economic status was seen, with the participants of middle socio-economic status adhering for longer duration (p=0.02). Age had weak and no significant correlation with percentage DARU (p=0.55). There was significantly fair correlation between motor function/functional use at any stage (p=0.55) and the corresponding percentage duration of adherence to restraint use, except the functional use in the first week (p=0.44).

 

Conclusion: Socio-economic status should be considered when applying CIMT.

Rehabilitation Services for Persons Affected by Stroke in Jordan

AL-ORAIBI, S
DAWSON, V L
BALLOCH, S
MOORE, A P
2011

Expand view

The purpose of this study was to explore the perceptions stroke survivors have of the rehabilitation services received by them in the Jordanian community. A secondary aim was to explore the impact of culture on providing appropriate services for stroke survivors.

 

Eighteen stroke survivors were recruited from an outpatient stroke rehabilitation programme. All 18 participants had been discharged from hospital for between one and six months. Semi-structured interviews were performed, either in thephysiotherapy outpatient clinic where the affected person was attending a clinic or in their homes. Transcription of interviews carried out in Arabic and thematic analysis was also carried out in that language by transcribers who were fluent in Arabic and English, using a back-translation method. Necessary measures were taken to ensure the accuracy, reliability and validity of the data collection and analysis.

 

Following thematic analysis, themes arising out of the data included physiotherapy and occupational therapy support in the community, out-patient rehabilitation clinic services, community clinic services and support from families, friends and neighbours. Participants expressed satisfaction with their therapists, but there were large areas of unmet rehabilitation need for stroke survivors in the Jordanian community such as a limited availability of occupational therapy services, insufficient amount of therapy services and poor medical support.

 

This study presents a unique contribution to knowledge relating to the experiences of stroke survivors in a developing country, and also shows how care systems are very dependent on cultural contexts, cultural beliefs and practices.

Pages

E-bulletin