The effect of bimanual therapy to functional hand movements in early stage of rehabilitation after stroke patients

Study subject: The effect of bimanual therapy for functional hand movements in early stage of rehabilitation. Background: stroke has been recognized as one of the basic reasons what concerns illness, death-rate and long-term disability all over the world. About 85 proc. of stroke patients, suffer from motor dysfunction of hand and leg, because of hemiparesis. Hand function is important for daily activities. It is known, that early after stoke patients rehabilitation can improve better motor function than latter rehabilitation. The aim: To evaluate the effect of bimanual therapy for functional hand movements in early stage of rehabilitation for after store rehabilitation. Study goals: 1. To evaluate functional hand movements in early stage for after stroke patients. 2. To evaluate functional movements of hand for patients who had bimanual therapy and who did not in early stage of rehabilitation. 3. To evaluate functional movements of hand for patients who had bimanual therapy and who did not in early stage of rehabilitation, after rehabilitation. Hypothesis: Bimanual therapy in early rehabilitation may have effect of functional hand movements in later rehabilitation for after stroke patients. Methods and measures: The research was made in Kaunas clinical hospital, neurological and physical medicine department, in 2014-2015 years. 40 after stroke patients participated. They were divided in two groups by accident: I group — bimanual therapy in early after stroke stage group (research group). II group — traditional physiotherapy group (control group). Patients in research group, had bimanual therapy for 20 min. every day. 8-10 days. Patients in control group had traditional physiotherapy for 20 min. every day. 8-10 days. After 8-10 days of research, all participants continued rehabilitation in physical medicine department and had the same physiotherapy as it is defined in this hospital policy. Patients’ affected hand strength was measured using a dynamometer, hand function was assessed by test a modified Motor Assessment Scale. Conclusions: 1. The results of functional hand movements before bimanual therapy and physical therapy application, suggests the movement disorder. There was no significant difference between groups in movements of functional hand movements (p<0.05). 2. There was statistically significant difference of results in I group and II group after early rehabilitation period compared with primary results (p<0.05). But results of shoulder bow, palm and complex hand movements were statistically significant better in I group compared to II group (p<0.05). 3. The results of functional hand movements after rehabilitation were statistically significant better in I group (p