IJPR.2019.108

Type of Article:  Original Research

Volume 7; Issue 2 (April 2019)

Page No.: 3028-3033

DOI: https://dx.doi.org/10.16965/ijpr.2019.108

EFFECT OF MASSED PRACTICE VERSUS DISTRIBUTED PRACTICE ON BASIC MOBILITY SKILLS AMONG POST STROKE PATIENTS

Parthiban Alagappan.

Senior Physiotherapist (Grade – II), Department of Physical Medicine & Rehabilitation, PSG IMS&R Hospitals, Coimbatore, Tamil Nadu, India.

Address for correspondence: Parthiban Alagappan, Senior Physiotherapist (Grade -II), Department of Physical Medicine and Rehabilitation, PSG IMS&R Hospitals, Coimbatore – 641004, Tamil Nadu, India. E-Mail: parthimpt13@gmail.com

ABSTRACT

Background: Stroke a global health problem is the second commonest cause of death and fourth leading cause of disability. Bed mobility the most important requisite for all activities in impaired in stroke.   Retraining of bed mobility skills is very important to gain  better outcome in the later phases of rehabilitation. Based on the concepts of motor learning there are numerous practice methods to retrain motor skills. Since sufficient literatures are not available in comparing the effect of massed practice and distributed practice on bed mobility skills among post stroke patients, there is a need for incorporating it in this study.

Objectives: To compare the effect of massed practice and distributed on basic mobility skills among post stroke patients.

Materials and Methods: Study was conducted as a quasi experimental design – pretest and posttest designs with two comparison treatments at the Department  of Physical Medicine and Rehabilitation ,KMCH Hospitals,  Coimbatore, Tamil  Nadu, India. A total of 20 stroke patients in the age group of 45 to 60 years participated in the study. The participants who satisfied the selection criteria were selected by convenience sampling and randomly assigned into two groups. Group A received bed mobility training using massed practice method and group B received bed mobility training using distributed practice method for 7 days. Outcomes were measured with bed mobility item of Stroke Rehabilitation Assessment of Movement (STREAM) scale.

Results: All participants in group A and group B showed significant improvement in bed mobility item of STREAM scale with a mean difference of 11.2 and 15.9 respectively. The calculated ‘t’ value using the paired test for group A and B were 27.03 and 51.36 (P<0.005) respectively. When comparing between the groups using independent ‘t’ test, the bed mobility item of STREAM scores showed mean difference of 4.9 and ‘t’ value of 9.7 (P<0.005).

Conclusion: This study revealed that there was significant improvement in bed mobility skills following distributed practice method than massed practice method among post stroke patients.

Key words: Massed practice, distributed practice, STREAM – Stroke Rehabilitation Assessment of Movement.

REFERENCES

  1. Adams RD, Victor M, Ropper AH. Cerebrovascular Disease. In: Adams RD, Victor M, Ropper AH, editors. Principles of Neurology. New York: McGraw-Hill, Health Professions Division, 1997;777-873.
  2. Da Cunha et al., Gait Outcomes After Acute Stroke Rehabilitation With Supported Treadmill Ambulation Training: A Randomized Controlled Pilot Study, Arch Phys Med Rehabil 2002;83:1258-65.
  3. Stefan Hesse Treadmill training with partial body weight support after stroke: A review NeuroRehabilitation 2007;22:1–11.
  4. Carr JH, Shepherd RB, editors. Movement Science: Foundations for Physical Therapy in Rehabilitation. Rockville, MD: Aspen; 1987.
  5. National Institute of Neurologic Disorders and Stroke.
  6. Anne Shumway-Cook, Marjorie Woollacott. Motor Control Theory and Applications. 3rd Lippincot Williams and Wilkins.
  7. Stacy L. Fritz et al., Active Finger Extension Predicts Outcomes After Constraint-Induced Movement Therapy for Individuals With Hemiparesis After Stroke. Stroke 2005; 36:1172-1177.
  8. Janet H. Carr, Roberta B. Shepherd. A Motor Relearning Programme for stroke, 2nd edition, Butterworth-Heinemann oxford publications.
  9. Gert Kwakkel et al., Functional Recovery After Stroke: A Review of Current Developments in Stroke Rehabilitation Research. Reviews on Recent Clinical Trials, 2006;1:75-80.
  10. Suzanne S Kuys et al., Higher-intensity treadmill walking during rehabilitation after stroke in feasible and not detrimental to walking pattern or quality: a pilot randomized trial. Clinical Rehabilitation 2011;25:316–326.
  11. Laura Adomaitis Vearrier, Jeanne Langan, Anne Shumway-Cook, Marjorie Woollacott . An intensive massed practice approach to retraining balance post-stroke. Published online 25 October 2004.
  12. Dettmers C, Teske U, Hamzei F, Uswatte G, Taub E, Weiller C. Distributed form of constraint-induced movement therapy improves functional outcome and quality of life after stroke. Third World Congress of Neurological Rehabilitation, April 2002, Venice.
  13. Nick et al., The timing of initiation of rehabilitation after stroke, Arch Phys Med Rehabil 2004.
  14. Steven R. Murray et al., Massed versus Distributed Practice: Which is Better? – Review, CAHPERD Journal, 2003;28(1).
  15. John W. Krakauer, Motor learning: its relevance to stroke recovery and neurorehabilitation. Current Opinion in Neurology 2006;19:84–90.
  16. Yousif Alshumaimeri, 14-12-01 Massed versus distributed, a review 14- 12 – 10.
  17. Conti GE, Schepens SL. Changes in hemiplegic grasp following distributed repetitive intervention: a case series.Occup Ther Int. 2009;16(3-4):204-17.

Cite this article: Parthiban Alagappan. EFFECT OF MASSED PRACTICE VERSUS DISTRIBUTED PRACTICE ON BASIC MOBILITY SKILLS AMONG POST STROKE PATIENTS. Int J Physiother Res 2019;7(2):3028-3033. DOI: 10.16965/ijpr.2019.108