[Clinical effects of intensive physiotherapy in stroke patients]

The present therapies used for post stroke patients are often not effective. Many patients finish the therapy and are not able to function independently. This situation is not in line with the present level of neurobiology: which states that function after focal lesion of C.N.S. can be recovered. Recently many studies have been undertaken which indicate the possibility of cortical plasticity by intensive physiotherapy. The main aims of the study were to review the efficacy and application of Constraint Induced Therapy for post stroke patients in a neurological rehabilitation ward and outpatient clinic. The group was selected from the patients who were admitted into the clinic. The patients signed the agreement that they could walk unaided and their affected arm could use a primitive grip. The patient's unaffected arm was restrained using a sling for 5 hours per day for 15 consecutive days. Also each patient had one hour per day of physiotherapy based on PNF and NDT Bobath concepts. Patients were tested before and after the experiment using functional tests (modified Wolf Test) and testing of motor deficit using Tests for the Quality of Movement Patterns (by Bobath). Seven patients were selected with an average time from stroke of 11 months. The average age was 46 years. All patients completed the study without any adverse affects. All patients increased their functional ability and decreased the motor deficit of the affected arm. The average increase in task function was 27%. The greatest average improvement (40%) was noted in chronic patients who suffered from stroke more than 6 months previous. The experiment was completed without any major reorganisation of the neurological ward and without additional expenditure. The small group of patients that participated in this study indicates that this CI therapy should be utilised for a larger amount of patients with greater neurological deficits.