Razi Journal of Medical Sciences

  Introduction: Balance and gait disorders are common motor complications after stroke. Studies have revealed that conventional physiotherapy cannot manage these disorders efficiently so more studies addressing the causes of these complications and presenting efficient treatment protocols are crucial.

  Methods: Thirty hemiparetic patients (age range 40-60 years old) participated in this experimental study. Patients were randomly divided in to 2 groups. One group received Constraint Induced Movement Therapy (CIMT) (group1) and the other Mass Practice (group 2) for 3 weeks. Experimental assessments included stride velocity and kinetic parameters of gait (amplitude and velocity of center of pressure sways of paretic and non-paretic limbs in sagittal and frontal planes) that were recorded and compared before and after treatment. For statistical analysis of data, if distribution of data was normal, parametric tests of t and pair t-tests were used. If distribution of data was not normal, non parametric tests of Wilcoxon and Mann-Whitney were used. SPSS V.11.5 was also used for data analysis.

  Results: In both groups, stride velocity increased (p=0.03, p=0.01). In CIMT group, COP sway for paretic and non-paretic limbs decreased in frontal plane (p=0.03, p=0.008). COP sway velocity for paretic limb decreased in both planes (p=0.01, p=0.03). For mass practice group, only COP sway amplitude for non-paretic limb decreased in sagittal plane (p=0.03).

  Conclusion: Physical therapy based on “Constraint Induced Movement Therapy” can more efficiently manage dynamic balance gait disorders by overcoming "learned non-use" phenomena and improving somato-sensory deafferentation to central motor controllers.