Physiotherapy based on problem-solving in upper limb function and neuroplasticity in chronic stroke patients: A case series

• Type: Article in International Scientific Journal
• Date: 2018

Authors

Carvalho, R (Author) Other; Elsa Azevedo (Author) FMUP; Marques, P (Author) Other; Dias, N (Author) Other; Cerqueira, JJ (Author) Other

Journal

Title: Journal of Evaluation in Clinical Practice

Vol. 24

Pages: 552-560

ISSN: 1356-1294

Publisher: Wiley-Blackwell

Indexing

ISI Web of Knowledge - 8 Citations

Scopus - 12 Citations

Other information

Authenticus ID: P-00R-AAT

DOI: 10.1111/jep.12921

Abstract (EN): Rationale, aims, and objectivesUpper limb recovery is one of the main concerns of stroke neurorehabilitation. Neuroplasticity might underlie such recovery, particularly in the chronic phase. The purpose of this study was to assess the effect of physiotherapy based on problem-solving in recovering arm function in chronic stroke patients and explore its neuroplastic changes. MethodsA small sample research design with a n of 3 using a pre-post test design was carried out. Neuroplasticity and function were assessed by using functional magnetic resonance imaging (during motor imagery and performance), action research arm test, motor assessment scale, and Fugl-Meyer assessment scale, at 3 sequential time periods: baseline(m0before a 4-week period without physiotherapy), pre-treatment(m1), and post-treatment(m2). Minimal clinical important differences and a recovery score were assessed. Assessors were blinded to moment assignment. Patients(1) underwent physiotherapy sessions, 50minutes, 5days/week for 4weeks. Four control subjects served as a reference for functional magnetic resonance imaging changes. ResultsAll patients recovered more than 20% after intervention. Stroke patients had similar increased areas as healthy subjects during motor execution but not during imagination at baseline. Consequently, all patients increased activity in the contralateral precentral area after intervention. ConclusionsThis study indicates that 4weeks of physiotherapy promoted the recovery of arm function and neuroplasticity in all chronic stroke patients. Future research is recommended to determine the efficacy of this therapy.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 9