Effect of Different Types of Inputs Combined with Contralateral Force Irradiation on Hand Function and Strength in Hemiplegia: (A Pilot study)

Abstract

Introduction: The contralateral force irradiation is based on fact that the stimulation of strong and preserved muscles produces activation of contralateral injured/weak muscles. Recent studies presented that somatosensorial inputs such as electrical stimulation or visual input increase the effect of force irradiation. Objectives:The aim of the study is to determine the effect of single-session only unilateral exercise training, pressure splint with unilateral exercise training and visual feedback with unilateral exercise training on hand function and strength in hemiplegia.Patients & methods:Hemiplegic patients (N=15) who applied to our clinic and whose mean age was 55.3±9.1 years, were randomly assigned to three groups (mirror (M), splint (S) and control (C) groups). All patients asked to squeeze the exercise ball 300 times with the unaffected hand. The affected limbs are into the mirror box in M group; into the Johnstone Splint in S group; on the table in C group without moving. Box-block test (BBT), hand grip strength (HGS (with a dynamometer) and pinch strength (PS) (with pinchmeter) were evaluated bilaterally before and after treatment. Wilcoxon Signed Ranks Test were performed for statistical analysis by using SPSS (Version 16.0; SPSS; Chicago, IL, USA). Results:The comparison between pre and post-treatment values showed that statistical significance was determined only in the mirror group of the affected hand on the BBT and PS scores (p=0.041, p=0.047, respectively). However, there was no significant difference in favor of a group in the pre and post-treatment changes of affected and unaffected hand (p>0.05).Conclusion: The studies showed that somatosensorial inputs promote contralateral force irradiation. We used mirror treatment as a visual input and Johnstone Splint as a proprioceptive input. The results of our study suggest that the kind of somatosensorial inputs altered the amount of contralateral force irradiation.Keywords: force irradiation, hemiplegia, visual feedback, air pressure splint.