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Master Thesis

Intérêt de la thérapie par contrainte induite du membre supérieur à la phase subaigue d'un AVC : revue de littérature

Abstract : Background: Stroke is the leading cause of acquired handicap in adults, the second leading cause of dementia and the second leading cause of death in France. Its frequency, severity and cost make it a real public health problem. Following a stroke, the hemiplegic patient usually develops a reaction called "acquired non-use" of the paretic limb, resulting in a severe impeding to its ability to recover. In order for the patient to be forced to use his or her affected limb, constraint induced therapy has been implemented, but to date its effectiveness has only been proven in the chronic phase of stroke. Objective: The objective of this literature review is to determine whether constraint induced therapy improves motor recovery of the paretic upper limb to the subacute phase of a stroke. Method: The PubMed, PEDro, Cochrane Library and Kinedoc databases were investigated. Only RCTs strictly compliant with the previously defined eligibility criteria were included. The methodological quality of the selected studies was assessed using the PEDro scale. Once the data was extracted, the results were analyzed qualitatively/narratively. Results: A total of 4 studies of 316 participants, considered medium to low methodological quality, were included. From the results obtained it would appear that this therapy has a benefit on the recovery of the motor function of the hemiplegic limb, however, although the changes in the control group were significantly smaller than the experimental group, the participants in the control group also showed significant improvement in most results at different follow-up periods. Among all the measurement tools, only the results on the MAS scale were to the detriment of the experimental group. Discussion: evaluation of the quality of the evidence demonstrated that these results were generally either statistically insignificant or clinically irrelevant, moreover, the studies are at high risk of bias which may skew the results. Therefore, current scientific data does not present enough evidence to conclude on the effectiveness of constraint-induced therapy in the subacute phase of stroke.
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Master Thesis
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Submitted on : Thursday, September 30, 2021 - 10:33:48 AM
Last modification on : Tuesday, October 19, 2021 - 10:35:20 PM
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Kelly Zouggari. Intérêt de la thérapie par contrainte induite du membre supérieur à la phase subaigue d'un AVC : revue de littérature. Médecine humaine et pathologie. 2021. ⟨dumas-03359362⟩



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