Mechanism and Efficacy of Rehabilitation Approaches

Mechanisms and Long-term Effects of Separate vs. Coupled Rehabilitation Approaches After Stroke

Identify the possible mechanisms and the relative effectiveness of existing rehabilitation approaches that target upper extremity deficits of stroke patients on the ground that these approaches are based on neuroplasticity principles and sound motor control theories.

Comparisons of constraint-induced therapy (CIT) vs. bilateral arm training (BIT)vs. combined therapy were made. Stroke patients will receive one of these three approaches and be evaluated pre- and post-treatment. the treatment will last 3 weeks and 5 days per week. The evaluation will include clinical measures of motor function, ADL, and quality of life, kinematic performance, and activation patterns of cortex.

Inclusion Criteria:

• a first-ever clinical cerebrovascular accident patients
• at least 6 months post-stroke onset
• premorbid right-hand dominance
• demonstration of Brunnstrom stage III of the affected upper extremity
• no excessive spasticity in the joints of the affected upper extremity

Exclusion Criteria:

• a score of less than 24 on the Mini Mental State Exam
• poor physical conditions that would interfere with participation
• excessive pain in any joint that might limit participation