The effect of constraint induced movement therapy on people after stroke

Uvod: Možganska kap je svetovni problem in eden izmed glavnih vzrokov invalidnosti. Ena izmed posledic možganske kapi, ki ovira predvsem opravljanje vsakodnevnih aktivnosti, je zmanjšana funkcija zgornjega uda. Samo 12 % ljudi je en teden po nastopu možganske kapi neodvisnih v opravljanju osnovnih dnevnih aktivnosti, po daljšem obdobju po možganski kapi pa je 74 % ljudi odvisnih od tuje pomoči na področju dnevnih aktivnosti, kot so hranjenje, skrb za osebno higieno in mobilnost. Namen: Namen diplomskega dela je raziskati učinkovitost z omejevanjem spodbujajoče terapije na osebe po možganski kapi. Metode dela: Uporabili smo pregled literature iz elektronskih bibliografskih baz podatkov – Google učenjak, COBISS in DiKUL s ključnimi besedami, kot so: z omejevanjem spodbujajoča terapija, možganska kap, rehabilitacija, delovna terapija. Rezultati: Rezultati so prikazani z diagramom PRISMA in ključnimi ugotovitvami študij, izbranih za pregled literature v razpredelnici. Razprava in sklep: Z omejevanjem spodbujajoča terapija je ena izmed redkih terapij, ki dokazano vpliva na motorične spretnosti in izboljšano kakovost življenja. Z omejevanjem spodbujajoča terapija ima vpliv na izboljšanje motoričnih spretnosti, povečan obseg giba, izboljšanje funkcije rame, izboljšanje fine in grobe motorike, izboljšanje povprečnega časa gibanja in časa, potrebnega za izvedbo nalog, boljšo stabilnost gibanja, zmanjšano spastičnost, bolj gladko gibanje ter boljšo mišično moč. Terapija je bolj učinkovita, če z njo pričnemo v zgodnji fazi po možganski kapi. Z omejevanjem spodbujajoča terapija je lahko bolj učinkovita v primerjavi z drugimi terapijami zaradi svojih lastnosti (intenzivnost, v funkcijo usmerjene aktivnosti, vaje z meritvami, omejitev zdravega zgornjega uda). Če ima terapija, s katero primerjamo z omejevanjem spodbujajočo terapijo približno enako število obravnav, lahko pridemo do podobnih rezultatov. Slabosti terapije so, da oseba po možganski kapi ves čas potrebuje nadzor (do šest ur na dan), zaradi intenzivnosti lahko terapija povzroča utrujenost, bolečino in depresijo.Introduction: Stroke is a worldwide problem and one of the main reasons for disability. One of the consequences that affect the ability to perform daily activities is a reduced function of the upper extremity. Just 12 % of the people who survived stroke stay independent in performing daily activities, but after a longer time after stroke, 74 % of the people need help in performing daily activities, such as feeding, care for personal hygiene and mobility. Purpose: The purpose of this study was to explore the effectiveness of the Constraint induced movement therapy on people after stroke. Methods: Literature review was conducted through databases Google Scholar, COBISS and DiKUL with the keywords like stroke, constraint induced movement therapy, rehabilitation, occupational therapy. Results: The results are shown with a diagram PRISMA and with the main findings from the studies that were chosen for the literature review in a table. Discussion and conclusion: The Constraint induced movement therapy is one of the rare therapies that have an improving effect on motor skills and an improved quality of life. The Constraint induced movement therapy has a positive effect on improving motor skills, increasing range of movement, improving shoulder function, fine and gross function of the affected upper extremity, time of movement and time required for accomplishing tasks, better stability of movement, reduced spasticity, smoother movement of the paretic upper limb and better muscle strength. The therapy is more effective when applied in an early stage after stroke. The Constraint induced movement therapy may be more effective compared to other therapies due to its properties (intensity, use of function-oriented activities, shaping, and limitation of healthy upper limb). If the therapy with which CIMT is compared has approximately the same amount of therapies, similar results can be obtained. The weaknesses of the therapy are that a person needs a clinical supervision most of the day (to 6 hours a day), it can cause depression, fatigue and pain