Alien Registration- Riley, Ansil W. (Calais, Washington County)

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Effectiveness of constraint induced movement therapy in improving upper limb function on patients with hemiplegia.

INTRODUCTION : Hemiplegic shoulder pain is a common complication after stroke with incidence rates ranging form 38-84% of cases. Pain is described as a sharp and stabbing and is more common on movement than rest. In spastic stage, abnormal Muscle tone may contribute to poor scapular position (Depression, retraction, downward rotation) and contributes to subluxation and restricted movement. Secondary tightness of ligaments, tendons and joint capsule can develop quietly and leading to pain during shoulder movement. For Functional assessment of upper limb dysfunction following measure were used: Functional independent scale, Barthel index, Kartz index, Fugl-meyer assessment scale, Modified barthel index, Performance based assessment. In this study Fugl-meyer assessment scale were used to assess the upper limb dysfunction. Constraint induced movement therapy is a rehabilitation approach that is designed to reduce in capitating motor deficits of the upper limbs in patient after neurological injury and increase their functional independence. AIM OF THE STUDY : The aim of the study is to know whether the constraint induced movement therapy is effective in improving upper limb function on patients with hemiplegia. An effective measure for the rehabilitation of stroke patients will certainly help both the patients and rehabilitation team. Thus, if this study is proved to be effective this can be used as an adjunct in the rehabilitation of hemiplegia. METHODS : A pilot study was conducted prior to the main study with subjects to observe the feasibility of study. After this, samples of subjects were selected using simple random sampling method from the population. All the participants were explained about the purpose and procedure of study and written consent was obtained from them before being included in the study. Pre test measurement of upper limb function was done using Fuglmeyer scale. Research Design - The study was quasi experimental in nature. Constraint induced movement therapy Pretest - Day 1 and Post test - 8Weeks. Pretest measurements of upper limb function was measured using Fugl - meyer scale. Criteria for selection : Inclusion Criteria - • Age 40-60 years, • Both sex, • Chronic stroke patients, • MCA involvement only, • Side - both side. Exclusion Criteria - • Shoulder dislocation, • Recent fractures, • Traumatic brain injury, • Cognitive impairment, • Cervical meylopathy, • Brachial plexus injury. Population - All the patients who fulfilled the selection criteria were taken as the population of the study. Sample size and method of selection - 10 samples were selected from the population using simple random sampling method. Variables : Independent variable - Constraint induced movement therapy Dependent Variable - Upper limb function. Validity and reliability of the tool used - Fugl-meyer scale is a valid and reliable tool to measure upper limb function. Setting - The study was conducted at the department of Post graduate studies of Vinayaka Missions College of physiotherapy, Salem and the patients were selected from VMKV medical college hospital, Salem. RESULTS : The data was subjected to statistical analysis and the following results were obtained. Constraint induced movement therapy is significantly effective in improving upper limb function on patients with Hemiplegia. CONCLUSION : It was concluded that constraint include movement therapy can be used as an effective adjunct in improving upper limb function on patients with Hemiplegia