Compliance of stress-induced therapy, controlled by actimeters

Introduction: In hemiplegia, constraint-induced movement therapy of the upper extremity has become a classic. The main difficulty of the method lies in its observance.

Objectives: Using actimeters to objectify membership protocol is proposed.

Methods: Two patients with stable paresis after stroke have received constraint-induced therapy for four weeks. Two actimeters (Actisleep ®) were placed one healthy side, the other side injured for 6 weeks, one before and one after restraint stress. A discussion with the patient is given after 3 weeks of recording. The clinical efficacy of treatment was assessed by dynamometry (Pablo ®) MESUPES and Jebsen test.

Results: For the first time, we were able to objectify the observance of the strain (80% observed for the first patient and 40% for the second patient). Quantification of movements by actimeter healthy side versus affected side was correlated with the results of motor and functional changes. Treatment despite very different adhesions was effective for both patients.

Discussion: The continuation of this study should determine the minimum level of compliance of the stress required to maintain the effectiveness of the method, while making it more tolerable as possible. It also opens a real chrono-biological perspective of movement and bi-handedness. Finally, the patient adheres more to the protocol because it knows observed and faces the quantification of stress at mid-test.

Conclusion: This new preliminary approach used here in the constraint-induced therapy of upper limb, presents actimeters as a new simple tool in the management of hemiplegia.