Teddy BOFOSA, Eric KAM, Betty MİANGİNDULA, Constant NKİAMA, Tharcisse KAYEMBE

Improvement of the functional recovery of the upper limb in hemiplegic patients by the use of the technique of induced stress therapy

Objectives: To investigate the effects of the induced stress therapy technique in functional recovery of the upper limb in hemiplegic patients. Methods: We conducted a longitudinal study that consisted in following the evolution of the functional recovery of the upper limbs of 60 hemiplegic subjects of the center for physical disabilities of Kinshasa subjected to a program of induced stress therapy for a period of six months from April 2018 to October 2018. The Fugl Meyer scale and Action Research Arm test allowed us to see the effects of this treatment. The parametric t test of student allowed us to compare the averages before and after the treatment.Results: After 6 months of the study, the results of our cases showed a very significant difference between the mean values of global motor skills scores at Action Research Arm between the beginning (51 ± 21%) and the end of treatment (64 ± 20%; p < 0.05). The difference in mean values at the Fugl Meyer scale was also very significant, both at overall scores and under-scores (p < 0.05). There is a very significant difference between older and younger patients compared to the mean values of their overall scores on the motor and independence scales (p < 0.05).Conclusions: We found that induced stress therapy significantly improved the level of functional recovery and autonomy at the Action Research Arm and Fugl Meyer scales. In addition, this improvement was a little slower in the hand than in the other segments of the upper limb.

Keywords:

induced stress therapy, functional recovery, hemiplegic, upper limb,

PDF

___

1. Bossa D. Guide pratique en cas d’hémiplégie, vignot édition, Paris, 1999: p. 255.
2. Person M. La rééducation de la préhension après un accident vasculaire cérébral: l’apport des nouvelles techniques. Kinesither Scient 2009;505:32-9. [Article in French]
3. Picard Y. Evaluation clinique de la motricité d’une personne adulte atteinte d’hémiplégie. Motricité cérébrale 2003;24:81-107.
4. Blanchard M. Vade-mecum de médecine pratique, 8ème édition, Masson et Cie, Paris, 2002: p. 277.
5. Bofosa T, Kam E, Njimbu F, Mpefi P, Kayembe T, Miagindula B, Impact of a program of induced stress therapy on the motor and functional recovery of the upper limb of hemiplegic patients in Kinshasa, Democratic Republic of Congo. J Surg Med 2018;2:339-43.
6. Kam E, Bofosa T, Lempira F, Malemba A, Nkongo H, Nkiama C, et al. Impact of lack of rehabilitation follow-up care on the functional level and autonomy of vascular hemiplegic patients at Kinshasa University clinics on homecoming. Med Sci Discovery 2018;5:274-78.
7. Recommandations de bonne pratique Accident vasculaire cérébral: Prise en charge précoce (alerte, phase pré hospitalière, phase hospitalière initiale, indications de la thrombolyse) HAS 2009.
8. Fery-Lemonniere E. Prévention et prise en charge des accidents vasculaires cérébraux en France, Rapport présentés au Ministère de la Santé et des Sports, ISRN SAN-DHOS/RE-09-2-FR, Juin 2009.
9. Wolf SL, Winstein CJ, Miller JP, Taub E, Uswatte G, Morris D, et al. Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke. The EXCITE randomized clinical trial. JAMA 2006,296:2095-104.
10. Daviet JC. Facteurs prédictifs du devenir vital et fonctionnel d’une cohorte d’hémiplégiques vasculaires. Conséquences sur les modalités de prise en charge, Thèse, Faculté de Médecine, Université Limoges; 2004.
11. Tshianga H. Trajectoires de services de réadaptation post-AVC Un continuum centré sur la personne, Rapport du Comité d’experts sur l’offre de services de réadaptation post-AVC Présidé par Carol L. Richards, O.C., Québec 2013.
12. Langhorne P, Coupar F, Pollock A. Motor recovery after stroke: a systematic review. Lancet Neurol 2009;8:741-54.
13. Carlsson CM, Stein JH. Cardiovascular diseases and the aging woman: overcoming barriers to lifestyle changes. Curr Womens Health Rep 2002;2:366-72.
14. Robinson RG. Poststroke depression: prevalence, diagnosis, treatment, and disease progression. Biol Psychiatry 2003;54:376-87.
15. Tshianga H. Impact des troubles cognitifs sur la récupération fonctionnelle et l’autonomie des patients en post AVC, Mémoire, Faculté de Médecine, Université de Kinshasa, Juin 2018.
16. Petit H. [What is the impact of initial prognosis factors on the efficacy and indications of rehabilitation following stroke?] Ann Readapt Med Phys 1997;40:113-20. [Article in French]
17. Meijer R, Ihnenfeldt DS, Van Limbeek J, Vermeulen M, Haan RJ. Prognostic factors for ambulation and activities of daily living in the subacute phase after stroke. A systematic review of the literature. Clin Rehabil 2003;17:119-29.
18. Feigenson JS, McCarthy ML, Greenberg SD, Feigenson WD. Factors influencing outcome and length of stay in a stroke rehabilitation unit. Part 2. Comparison of 318 screened and 248 unscreened patients. Stroke 1977; 8:651-62.
19. Granger CV, Hamilton BB, Fiedler RC. Discharge outcome after stroke rehabilitation. Stroke 1992;23:978-82.