Does use of the optokinetic chart stimulation based OKCSIB protocol improve recovery of upper and lower limb movements, function and quality of life at 3 year follow up in dense strokes? A retrospective case control series

NeuroRehabilitation. 2014;35(3):451-8. doi: 10.3233/NRE-141135.

Abstract

Background and objective: The aim was to compare follow up impairment, function and quality of life outcomes between dense parietal centred strokes treated by the optokinetic chart based OKCSIB protocol and those treated by conventional neuro-physiotherapy.

Design and setting: Follow up retrospective case control series in the community.

Method and materials: 643 persons with stroke were eligible for initial screening to see if they met inclusion criteria. Only 37 potential participants were eligible, with 18 of them still alive. From the 18 only 8 consented to participate in the follow up study.

Results: Sixteen mortalities that occurred post discharge were all from the conventional group. The OKCSIB group had statistically significant improved upper limb STREAM scores (p < 0.05). The OKCSIB group had statistically significant reduction in hand spasticity with none of the OKCSIB participants developing hand spasticity (p < 0.05). The OKCSIB group also had better lower limb STREAM scores although these were not statistically significant (p > 0.05). Barthel Index, and quality of Life improvements were non-significant (p > 0.05).

Conclusion: The OKCSIB protocol led to better recovery of voluntary movements at 3 year follow up. However lack of randomisation and the small number of participants, necessitate further research to be carried out.

Keywords: Dense acute parietal strokes; OKCSIB protocol; lower limb recovery; neuro-physiotherapy; optokinetic chart stimulation; upper limb recovery.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Clinical Protocols
  • Cohort Studies
  • Costs and Cost Analysis
  • Female
  • Follow-Up Studies
  • Hand / physiopathology
  • Humans
  • Lower Extremity / physiopathology
  • Male
  • Movement
  • Muscle Spasticity / etiology
  • Muscle Spasticity / rehabilitation
  • Neurologic Examination
  • Physical Therapy Modalities
  • Quality of Life
  • Retrospective Studies
  • Stroke / economics
  • Stroke / mortality
  • Stroke Rehabilitation*
  • Treatment Outcome
  • Upper Extremity / physiopathology