Comparied treatment results of passive motion and margaret johnstone method on the upper extremity of cerebrovasculer accidents

This study was planned to determine the effects of Continuous Passive Motion (CPM) device and Margaret Johnstone Method to regain losted ability and functional of upper extremity, motor control and sensorial perception. 22 chronic patients with cerebrovasculer accident (CVA) treated in Neurosurgery and Neurology deparment of zzet Baysal Bolu Goverment Hospital and Köroglu Goverment Hospital between January 2005 and December 2006, joined this study. Being randomized, upper extremity of 11 patients was treated with using the pressure splints as neurophysiologic approach improved by Margaret Johnstone and upper extremity other 11 patients was treated with using CPM device and pasif motion protocol together. Lower extremity of both groups was treated with neurophysiologic approachs (Bobath and Brunnstrom). Both groups were being applied treatment programme three times a week during six week. On patients pre-evaluated with Hemiplegia Assesment Form, motor function impairment with Fugl-Meyer Assessment (FMA) and Motor Assessment Scale (MAS), daily-living activities with Functional Independence Measurement (FIM) and measurements of spasticity with Modify Ashworth Scale were evaluated before and after treatment. After treatment, daily-living activities, level of spasticity and functional motor performans were observed improvement significantly (p<0.05). No significantly differences were found when the total score before threatment compared with the total scor after treatment. But when subgroups of applied evaluation methods were examined, significantly differences were observed at normal Range of Motion in groups used CPM device (p<0.05).The functional improvements of upper arm of Margaret Johnstone groups were significant with respect CPM devices groups (p<0.05). Although, there was no significant differences when compare the evaluation of upper extremity in both groups, muscle tonus were observed beter. With respect to these findings, it was suggested that using CPM device and pressure splints combine withother treatment methods together by physical therapist were beneficial in hemiplegia rehabilitation which improved after serebrovasculer disease. Key words: Serebrovasculer Disease, Serebrovasculer Accident, Hemiplegia, Contionuous Passive Motion (CPM) Device, Pressure Splint, Stroke