REPETITIVE TRAINING OF ISOLATED MOVEMENTS IMPROVES THE OUTCOME OF MOTOR REHABILITATION OF THE CENTRALLY PARETIC HAND

The effect of a standardized training on movements of the affected han d has been studied in 27 hemiparetic patients using a multiple baselin e approach across individuals. The training consisted of repetitive ha nd and finger flexions and extensions against various loads and was ca rried out twice daily during 15-min periods. Grip strength (p < 0.006) , peak force of isometric hand extensions (p < 0.05), peak acceleratio n (p < 0.05) of isotonic hand extensions as well as contraction veloci ties as indicators of motor performance significantly improved during the training period. In contrast to the standardized training of hand and finger movements, therapeutic strategies following the Bobath conc ept aim at reducing enhanced muscle tone without reinforcing the activ ity in centrally paretic distal muscle groups directly. Patients under going this treatment approach alone did not experience a significant i mprovement in the motor capacity of the hand. Therefore, the results o f the present study emphasize the importance of frequent movement repe tition for the motor rehabilitation of the centrally paretic hand and challenge conventional physiotherapeutic strategies that focus on spas ticity reduction instead of early initiation of active movements.