To compare the hand therapy protocols based on Brunnstrom approach and motor relearning program in rehabilitation of the hand of chronic stroke patients.
Design: Randomized trial.
Setting: Outpatients attending the occupational therapy department of a rehabilitation institute.
Subjects: 30 post-stroke subjects (35.06聽卤聽14.52 months) were randomly assigned into two equal groups (Group A and Group B), Outcome Measures: Brunnstrom recovery stages of hand (BRS-H), Fugl-Meyer assessment: wrist and hand (FMA-WH).
Intervention: Group A received Brunnstrom hand manipulation (BHM). BHM is the hand treatment protocol of the Brunnstrom movement therapy, which uses synergies and reflexes to develop voluntary motor control. Group B received the Motor Relearning Program (MRP) based hand protocol. MRP is the practice of specific motor skills, which results in the ability to perform a task. Active practice of context-specific motor task such as reaching and grasping helps regain the lost motor functions.
Both the therapy protocols were effective in rehabilitation of the hand (BRS-H; p聽=聽0.003 to 0.004, FMA-WH; p聽<聽0.001). However, the results were statistically significant in favor of group A undergoing BHM for FMA-WH (p聽<聽0.004) and FMA item VIII (hand motor recovery) (p聽<聽0.033).
BHM was found to be more effective than MRP in rehabilitation of the hand in chronic post-stroke patients.