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Cortical activation after constraint induced movement therapy in stroke patients: A randomized controlled trial

Gehan M. Ahmed, Ebtesam M. Fahmy, Saly H. Elkholy, MoatazEl Semary, Abeer A. Mohammed, Wanees M. Badawy


Background: Constrained induced movement therapy (CIMT) has been a neurorehabilitation method that proved to improve arm function and induce neural plasticity after stroke. However, there have been limited controlled trials discussing the cortical activity changes after CIMT in chronic stroke. Objective: This study aimed to scrutinize the effect of adding a constraint induced movement therapy to the intensive physical therapy program on cortical activity and functional outcome of the upper extremity in patients with chronic stroke. Subjects and Methods: Forty stroke patients were included. They were randomly assigned into two equal groups; study group received functional training with CIMT in addition to intensive physical therapy program, and the control group received intensive physical therapy program only. The outcome measures included: the motor function of the upper extremity using the Wolf Motor Function Test (WMFT), and the cortical activity of the affected cerebral hemisphere using the Quantitative Electroencephalogram (QEEG). Results: There was a significant increase in WMFT mean scores in the study and control groups post treatment (P<0.0001, 0.015 respectively), with remarkable improvement in the study group (P= 0.0496). A statistically significant increase in alpha wave frequency, relative and maximum power post treatment in the study group was only (p<0.05). A statistically significant decrease in theta wave, relative and maximum power was also detected in the study group post treatment (P=0.0091, 0.0176 respectively). A statistically significant difference was observed between both groups regarding post treatment of mean values of alpha and theta waves variables (p<0.05), except for theta wave frequency (p=0.308). Conclusion: CIMT improved the motor function of upper extremity and was associated with increased cortical activation of the affected hemisphere in patients with chronic stroke.

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