A New Primary Care Model for the Rehabilitation of Strokepatients with Impaired Arm and Hand Function — A Pilot Study

Abstract

Background:

A new treatment method, Constraint-Induced Movement Therapy (CIMT), has been tested by stroke patients in hospital but not in primary care. Reduced time in hospital increases primary care's responsibility for rehabilitation and necessitates the development of new methods.

Aim:

To investigate the effect of CIMT on stroke patients in primary care.

Method:

Sixteen patients with stroke were offered a ten-day intensive group-training course, six hours per day. They were included in median value 17 months (range: 7–120) after stroke. They were prevented from using their non-affected hand by wearing a glove for 90% of their waking hours. Measurements with 14 standardized instruments were performed up to three months after intervention.

Findings:

The results revealed a significant improvement in the patients' motor and everyday life functions. There was a marked recovery of lost capacity in ADL, which combined with the increase in the performance of meaningful tasks led to improved possibilities of living an independent life. The improvements in motor function and recovery of lost ADL functions were maintained at the three month follow-up. The training intervention was perceived as highly satisfactory.

Conclusion:

CIMT in a group setting in primary health care seems to be a successful rehabilitation model after stroke.