|Title:||Efficacy of motor relearning program in improving function after stroke|
|Subject:||Cerebrovascular disease -- Patients -- Rehabilitation|
Hong Kong Polytechnic University -- Dissertations
Department of Rehabilitation Sciences
|Pages:||xiii, 162 leaves : ill. ; 30 cm|
|Abstract:||Introduction: Occupational therapists play an important role in training patient's abilities in self-care, work and leisure. This study aimed to design a standardized clinical program based on the motor relearning theory for improving functional balance and test its efficacy on the functional balance and cognitive parameters. Method: A total of 52 out-patients suffered from stroke within one year in a rehabilitation setting were matched with demographic characteristics on admission. They were randomly assigned to either an experimental or a control group. The patients in the experimental group received six-week motor relearning program (MRP) with a schedule of three two-hour sessions per week. With the same schedule, the patients in the control group received conventional occupational therapy. All patients were assessed at admission, 2-week, 4-week and 6-week with the Functional Independence Measure (FIM), Berg's Balance Scale (BBS), Timed Up and Go Test, Instrumental Activities of Daily Living (IADL) Assessment of Elderly and Community Integration Questionnaire (CIQ), and Neurobehavioral Cognitive Status Examination (Cognistat). Results: The efficacy of the MRP was supported with significant differences in the balance and cognitive functions of patients between the experimental and control groups (F(9,23)=4.55, p<0.001) and within each of the two groups (F(27,23)=5.38, p<0.001). Multiple comparison tests indicated that patients in the experimental group had significant and steady improvements in functional balance across all assessment intervals. Patients in the experimental group had significantly higher cognitive abilities in orientation, comprehension and memory across all assessment intervals than those in the control group. Conclusion: The MRP was found effective in improving the balance and function of patients with stroke. However, its efficacy of promoting cognitive gains still requires further substantiation. The MRP appeared to be useful in enhancing the patients to generalize their skills learnt in the program to independent functioning at home and community integration. Such results further illustrate the contributions of remedial activities, balance skills and functional training as the media in enhancing patients' independence in daily task performance. These positive findings support the interventions for the upper limb dysfunction of patients with stroke. The application of MRT adds theoretical and operational enrichment to the motor relearning theory. Results of this study also provides scientific foundation for evidence based practice in stroke rehabilitation.|
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