The level of functionality of the affected upper limb in stroke patients depends on the type of therapy used and the lateralization of the subjects’ body – A randomized observational study

Abstract

Introduction: Impairment of the functions of the upper limb and hand is a major problem in stroke patients. The aim of the study was to evaluate various therapies in terms of their influence on changes in the activity of the affected, dominant, and non-dominant upper limb in patients after ischemic stroke. Material/Methods: This is a randomized, double-blinded study. The research was carried out in a rehabilitation clinic on a group of 60 stroke patients who were randomly assigned to groups differing in the rehabilitation program. The study group had physiotherapy based on the NDT Bobath concept and the control group used classic exercises. The importance of the trunk for the upper limb coordination was assessed on the Armeo®Spring device using three evaluation programs: “vertical fishing”; “horizontal fishing”; “reaction time” and two proprietary tests: “wall” and “abacus”. Results: Post-treatment analysis showed significantly better results in the study group (dominant limb). There was an improvement in the grip ability – the abacus test (p = 0.023), an increase in the mobility of the shoulder joint in the sagittal plane – the wall test (p = 0.002), and an increase in the speed of movements in the transverse plane – vertical fishing – time (p = 0.001). The functional improvement of the dominant limb is also evidenced by a significant difference in the reaction time – task performance test [%] (p = 0.048). Conclusions: Physio-therapy, in accordance with the NDT Bobath concept, aimed at improving trunk stability has a significant impact on increasing the mobility, speed of movement, and reaction time in the shoulder joint, and improves the handgrip ability of the affected dominant upper limb.