Role of less affected upper extremity in post stroke rehabilitation

Background: The damage of some fibers of the corticospinal tract may lead tomild to moderate impairment on sound side also. The sound side (the"unaffected"side) is often considered a reference point.It is thereforeassumed that this side has no deficit. Nevertheless,previousresearch suggests or tends to show diminished strength intheunaffected upper limb whencomparedwithhealthy subjects. However, the rehabilitation protocols emphasized only on theaffected side. In spite of this majority of the stroke population do not achievecomplete or satisfactory motor recovery of the affected side.  Animal studies have shown that the retrainingof the less affected side also, leads to better cortical reorganization whichin turn add up  to improved motorrecovery of the affected upper limb.

Objectives

·       Tostudy the level of impairment in less affected upper extremity of strokepatients

·       Tocompare the  preference between dominantand non-dominant less affected hand

·       Todevelop Occupational therapy intervention protocol focused on intralimb(bilateral upper limb) coordination and exclusive strengthening & dexteritytraining of the less affected side

·      Tostudy the effect of the protocol in comparison to the conventional program

Methodology

StudyDesign: Part- I Comparison of less affected upper limb of post stroke patients withmatched able body individuals (Non-experimental: observational). Part-IIComparison of the new treatment protocol with the conventional (experimental;randomized controlled trial)Place of study: Department of Occupational Therapy, PDUIPH

Inclusioncriteria**:** Age: 40 to 60 year, bothmale & female**,** Hemiparesis(right / left), unilateral stroke(Ischemic / hemmorhagic), 4 to 12 months after stroke

Exclusioncriteria**:** Receptive communicationdisorder**,** Cerebellar or thalamicinfarct**,** Uncontrolledsystemic  or cardiovascular disease**,multiple stroke,** Ataxia**,** Severecognitive / perceptual deficit

 Samplesize:  30 post strokepatients (Pilot study) and 30 matched able body individuals (Allthe participants will be enrolled after obtaining signed informed consent form)

SamplingMethod: Sample of convenience, Random assignment

Outcomemeasures: Purdue peg board test, Minnesota rate ofmanipulation test (MRMT) (Both themeasures are already available in the Department of Occupational therapy,PDUIPH

Deliverableoutcomes

·       Thepresent study will lead to development of rehabilitation protocol whichencompasses less affected side also.

·      Assessmentand training of less affected upper extremity will enhance better motor andfunctional outcome in post stroke survivors.