All ETDs from UAB

Advisory Committee Chair

David M Morris

Advisory Committee Members

Elizabeth Barstow

Christopher Hurt

Victor Mark

Edward Taub

Brooks Wingo

Document Type

Dissertation

Date of Award

2018

Degree Name by School

Doctor of Philosophy (PhD) School of Health Professions

Abstract

Walking impairment after stroke impacts on participation and quality of life. Different techniques have been developed in the last decades to overcome walking difficulties after stroke, however, few have been shown to be efficacious. Constraint-induced Movement Therapy (CIMT) is a family of techniques that has been reported as one the most effective intervention for improving functional use and motor skills of a more-affected upper extremity (UE). The intervention protocol includes: 1) intensive supervised training; 2) use of shaping as a strategy for the motor training, 3) a group of behavioral strategies called the transfer package, and 4) procedures to increase the use of the more affected UE including the restraint of the less affected UE. The UE-CIMT protocol has been modified for use with the lower extremity (LE) and a few studies have examined the effect of the LE-CIMT on LE function. However, the studies that have applied the LE-CIMT protocol in people with stroke did not use the complete protocol (i.e., with a fully developed transfer package). Thus, information about the effects of the complete LE-CIMT protocol is greatly needed. The purpose of this mixed methods study was to investigate the relationship between the effect of the LE-CIMT protocol on gait, mobility and motor function, and examine participants` and caregivers` perceptions regarding the treatment. The comparison of the scores obtained during pre-, post-treatment and follow up assessments suggest that the LE-CIMT is a potential tool to improve gait, mobility and use of the more affected LE of people with chronic stroke. The results were maintained three months after the end of the treatment. The quantitative results were validated by the perceptions of both caregiver or family members and participants with stroke. Further investigation about the effect of LE-CIMT in comparison with other interventions still needed. Also, studies with larger sample size should be conducted.

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