Effects of CIMT in Parkinson's Disease Patients
Condition: Parkinson Disease
MeSH terms: Parkinson Disease
Study type: Interventional

Summary: 
      The purpose of the study was to determine the effects of constraint induced movement therapy
      on hand and arm functions in Parkinson's disease patients. It was a randomized controlled
      trial, conducted in physical therapy department of University of Lahore Teaching Hospital,
      Mayo Hospital and Lahore General Hospital. 40, male and female Parkinson's disease patients
      aged between 50-80 years were randomly allocated into two equal groups. In experimental group
      patients were treated with constraint induced movement therapy and routine physical therapy
      and in control group patients were treated with routine physical therapy. Patients were
      treated for a total of 4 weeks, 6 hours in a day. Patients were assessed using Frenchay Arm
      Test (FAT). SPSS 25 was used to analyze the data.
    

Detailed description: 
      One of the central nervous system's most frequent diseases is Parkinson's disease (PD). In
      individuals with PD upper limb impairments could be present such as resting tremor or
      micrographia, often the first symptom of the disorder. These upper limb conditions can lead
      to difficulties in work, leisure, and everyday activities such as eating and dressing as the
      disease advances. This research was aimed to provide insightful information for both
      clinicians, researchers and for community in general. This study was helpful in the field of
      neurorehabilitation to bridge the gaps of previous researches. Clinician or
      neurorehabilitation expert can apply the more useful technique on patients and get the better
      results in less time. Researchers can find the high-quality clinical evidence regarding
      constraint induced movement therapy on Parkinson's patients. According to evidence-based
      practice patient preference is considered in providing treatments to patients. So, patient
      can find out which treatment is better.

      40 patients who fulfill the inclusion criteria were enrolled in this study. Written informed
      consent was taken from every subject participating in this study. Allocation of subjects in
      two groups was done by random number table. Group A was treated with Constrained Induced
      movement therapy along with routine physical therapy and group B was treated only with
      routine physical therapy. In routine physical therapy group patients received intervention
      according to systematic review and clinical guidelines that worked on aerobic capacity,
      muscle strengthening exercise, walking ability, postural and balance disorders and improving
      hand arm function.39 Three stages were used in each session: (i) warm-up phase: passive
      mobilization of major joints and lower limb muscle strengthening; (ii) active phase (both
      standing and sitting): motor control exercises for upper and lower limbs, and (iii) cool-down
      phase (in seating position): respiratory exercises and mobilization.

      40 The routine or baseline therapy was remained same throughout the study. Constraint induced
      movement therapy was given to group A for four weeks. Training was done for 6 hrs/day, 5
      days/week for 4 weeks. All the information wascollected by using standardized questionnaire
      of Frenchay arm test. Confounding variables were controlled by randomization and restriction
      methods. All treatment was given by single therapist to control the biasness.
    

Intervention name(s): Constraint Induced Movement Therapy and Routine Physical Therapy; Routine Physical Therapy
Intervention type(s): Other; Other
Intervention description(s): Intensive, graded practice of the paretic upper limb to enhance task-specific use of the affected limb. Constraint or forced use therapy, with the non-paretic upper limb contained in a mitt to promote the use of the impaired limb during 90% of the total hours awake. Adherence enhancing behavioral methods designed to transfer the gains obtained in the clinical setting or the laboratory to patients' real-world environment (ie, a transfer package).
As part of routine physical therapy patients received intervention that worked on aerobic capacity, muscle strengthening exercise, walking ability, postural and balance disorders and improving hand arm function. Three stages were used in each session: (i) warm-up phase: passive mobilization of major joints and lower limb muscle strengthening; (ii) active phase (both standing and sitting): motor control exercises for upper and lower limbs, and (iii) cool down phase (in seating position): respiratory exercises and mobilization.; As part of routine physical therapy patients received intervention that worked on aerobic capacity, muscle strengthening exercise, walking ability, postural and balance disorders and improving hand arm function. Three stages were used in each session: (i) warm-up phase: passive mobilization of major joints and lower limb muscle strengthening; (ii) active phase (both standing and sitting): motor control exercises for upper and lower limbs, and (iii) cool down phase (in seating position): respiratory exercises and mobilization.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: It was a parallel group, randomized controlled trial of 40 Parkinson's disease patients enrolled between December 2020 to Feb 2021.
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Constraint induced movement therapy; Upper limb; Physical therapy; Exercise