Neurorehabilitation » Methods of Neurorehabilitation » Induced restriction therapy in restoring the motor function
Induced restriction therapy in restoring the motor function
Induced restriction therapy is a concept that helps doctors to restore motor and other types of dysfunction in patients with neurophysiological damages, that appeared, for example, after a stroke. The most significant progress was achieved when this method was applied in restoring function of the paralyzed hand.
Basically, induced restriction therapy follows three principles:
- Restriction: it is necessary to prevent the patient from trying to replace the lost function by applying other preserved functions.
- Coercion: patient needs to be put in such situation (it needs to be simulated), where he/she will have to use the lost function.
- Intensity: only by practicing continually and persistently it is possible to achieve significant results.
One example of restoring the mobility of the hand with this method: patient's healthy arm is placed in the restraining tire, then conditions that cause the instinctive activity of the hands or that require some movement on the part of the patient are recreated. Thus, the patient is forced to use his/her paralyzed (partially paralyzed) arm. This gradually leads to restoration of the motor function. It should be noted that without such forced limitations, the body tend to adapt the paralyzed hand in such a way that the patient ceases to use it. As a result of this, the chances of recovery, of course, diminish. It is also important to note that such technique requires patient to apply his/her patience and considerable efforts. This is the main difference of this technique from other types of neurorehabilitation, which, as a rule, do not require effort of will.
From a medical point of view, when all of these 3 principles are followed, the process of cortical restoration of the brain is activated. This method can be very effective. For example, as a result of a 6-hour procedures that were held 5 days a week for a duration of 3 weeks, a 60-year-old patient who could not move her left fingers and could hardly bend her elbow joint after a stroke, was able to hold a bottle of water in her left hand and eat a sandwich.
Effectiveness of the method
Recently, a study was conducted to determine the effectiveness of the induced restriction method in a more accurate way. 41 stroke patients with motor disorders of the upper extremities that ranged from mild to moderate were involved in this study. The average age of the patients was 53 years and the average time that passed after the stroke was 4.5 years. A group of 21 patients underwent stroke rehabilitation by practicing the induced restriction method. The practices that lasted for 6 hours were held for 10 straight days without interruptions. Another group of 21 people underwent general physiotherapy, muscle strengthening and toning, as well as various cognitive games and exercises for relaxation. The program lasted 6 hours each session for 10 days as well.
In the first group, all patients without exception had progress results, that were characterized as "significant" and "very significant". In another group, there were no positive changes in the mobility of the paralyzed limb. It should also be noted that in other areas of rehabilitation (for example, cognitive), the first group experienced more significant improvements as well.
The same test was repeated 2 years later (program was completed by both groups so that the long-term results of therapy could be studied). The results fully confirmed the effectiveness of the induced restriction therapy: patients of the first group improved their condition significantly whereas patients of the second group remained approximately at the same level as before the clinical trial.
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