Efficacy of the combined approach (involving the constraint-induced movement, orthosis,neuro-muscular electrical stimulation, and robotics therapies) for bilateral upper limb paralysis after multi-focal stroke in the sub-acute phase:

A case study

Abstract

Purpose:To illustrate the treatment of a sub-acute patient with bilateral upper-limb paresis using several approaches. Method:Constraint-induced movement therapy (CIMT) combined with the orthosis and neuro-muscular electrical stimulation therapy for one to two hours per day was used. In addition, to treat the more affected left upper-limb, robotic therapy was used as a self-training for 0.5 hours per day. These approaches were tailored to the improve the function of the upper-limb disorder for 34 days. Results:Several upper-limb outcomes of bilateral upper limb function improved beyond the minimal clinical important difference. Conclusion:Combining several evidence-based approaches of the stroke-induced hemiparetic arm might benefit sub-acute multi-focal stroke patients with bilateral upper-limb paresis.