Functional outcome of joint mobilization added to task-oriented training on hand function in chronic stroke patients

Abstract

Abstract Background Approximately half of stroke patients show impaired upper limb and hand function. Task-oriented training focuses on functional tasks, while joint mobilization technique aims to restore the accessory movements of the joints. Objective To investigate the effect of adding joint mobilization to task-oriented training to help the patients in reaching a satisfactory level of recovery for their hand function. Patients and methods Thirty chronic stroke patients with paretic hand participated in the study; they were divided equally into study and control groups. The study group received joint mobilization followed by task-oriented training for the affected hand. Meanwhile, the control group received task-oriented training only. Both groups received their treatment in the form of 3 sessions per week for 6 successive weeks. The primary outcome measures were hand function that was assessed by Jebsen-Taylor hand function test (JTT) and active and passive wrist extension range of motion (ROM) that was measured by a standard goniometer. The secondary outcome measure was the grip strength of the hand that was assessed by a JAMAR adjustable hand dynamometer. Results There was a significant improvement in all the outcome measurements in both groups that were more evident in the study group. Conclusion Combining joint mobilization with task-oriented training had a highly significant effect in improving the hand function in chronic stroke patients compared to task-oriented training alone.

Keywords

• Stroke
• Spasticity
• Hand function
• Joint mobilization
• Task-oriented training