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. 2024 Oct 3:56:jrm24168.
doi: 10.2340/jrm.v56.24168.

Positive effects of lower extremity constraint-induced movement therapy on balance, leg strength and dual-task ability in stroke patients: a longitudinal cohort study

Annika Sefastsson  1 , Ingela Marklund  2 , Håkan Littbrand  3 , Per Wester  4 , Britt-Marie Stålnacke  5 , Ann Sörlin  5 , Birgitta Langhammer  6 , Per Liv  7 , Xiaolei Hu  8
Affiliations

Positive effects of lower extremity constraint-induced movement therapy on balance, leg strength and dual-task ability in stroke patients: a longitudinal cohort study

Annika Sefastsson et al. J Rehabil Med. .

Abstract

Objective: To investigate whether high-intensity lower extremity constraint-induced movement therapy can improve balance, leg strength, and dual-task ability.

Design: A longitudinal cohort study in a real-world outpatient clinic.

Patients: 147 community-dwelling participants in the subacute and chronic poststroke phases.

Methods: Participants received lower extremity constraint-induced movement therapy for 6 hours/day during 2 consecutive weeks, including balance, strength, and functional training. The Berg Balance Scale (BBS), Single-Leg-Stance (SLS) bilaterally, one Repetition Maximum (1RM) in a leg press, symmetry of leg strength (Diff-1RM), Timed Up and Go (TUG), and the TUG Manual test were assessed before, after, and 3 months after lower extremity constraint-induced movement therapy.

Results: Compared with preintervention data, statistically significant improvements after lower extremity constraint-induced movement therapy (p < 0.001) were demonstrated for balance with an absolute value in BBS at 1.9 points (effect size 0.38) and SLS at 2.4 s (effect size 0.24), and for leg strength at 10.2 kg (effect size 0.54) for the affected leg. Diff 1RM decreased significantly at 5.8 kg (effect size 0.39) and improvements on dual-task ability at 2.7 s were significant (effect size 0.14). The effects persisted at the 3-month follow-up.

Conclusions: High-intensity lower extremity constraint-induced movement therapy may be a feasible treatment option for middle-aged stroke patients to affect balance, leg strength, and dual-task ability positively in an out-patient clinical setting.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Flowchart of participant recruitment.
Fig. 2
Fig. 2
Improvements in balance assessed by the Berg Balance Scale (A) and single leg stance (B).
Fig. 3
Fig. 3
Improvements in leg strength for the (A) nonaffected and (B) affected leg and (C) the difference in leg strength between the nonaffected and affected legs.
Fig. 4
Fig. 4
Results for dual task assessed by the (A) TUG Manual test compared with (B) TUG test.
See this image and copyright information in PMC

References

    1. Langhorne P, Bernhardt J, Kwakkel G. Stroke rehabilitation. Lancet 2011; 377: 1693–1702. 10.1016/S0140-6736(11)60325-5 - DOI - PubMed
    1. Flansbjer UB, Downham D, Lexell J. Knee muscle strength, gait performance, and perceived participation after stroke. Arch Phys Med Rehabil 2006; 87: 974–980. 10.1016/j.apmr.2006.03.008 - DOI - PubMed
    1. Dorsch S, Ada L, Canning CG. Lower limb strength is significantly impaired in all muscle groups in ambulatory people with chronic stroke: a cross-sectional study. Arch Phys Med Rehabil 2016; 97: 522–527. 10.1016/j.apmr.2015.10.106 - DOI - PubMed
    1. Chan PP, Si Tou JI, Tse MM, Ng SS. Reliability and validity of the timed up and go test with a motor task in people with chronic stroke. Arch Phys Med Rehabil 2017; 98: 2213–2220. 10.1016/j.apmr.2017.03.008 - DOI - PubMed
    1. Xu T, Clemson L, O’Loughlin K, Lannin NA, Dean C, Koh G. Risk factors for falls in community stroke survivors: a systematic review and meta-analysis. Arch Phys Med Rehabil 2018; 99: 563–573 e565. 10.1016/j.apmr.2017.06.032 - DOI - PubMed

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