Comparison of Mergaret-Johnstone and Todd-Davies methods in early rehabilitation pf hemiplegic patients

Mehmet Karakaya, Nezire Köse, Saadet Otman,Tunçalp Özgen

Sixty patients whose mean age was 46,21± 13.70 years, with a range of 20 to 69 years, and who participated in an acute rehabilitation program between 1991 and 1996 at Neurosurgery Unit, School of Physical Therapy and Rehabilitation, Hacettepe University, were included in this study. 44 patients (73.3 %) had an intracranial tumour and 16 patients (26,7 %) had both an intracranial aneurysm and hemorrhage. Patients were divided homogenously and equally into two groups, and 30 patients underwent Todd-Davies treatment and other 30 patients underwent Margaret Johnstone treatment methods. In this study, the effects of two different neuropysiological approaches on the independency of the hemiplegic patients in functional activities were investigate. The results of this study revealed that recovery levels of the muscle tone and functional activities in the Margaret Johnstone treatment group were significantly higher than that of Todd-Davies group (p<0.05). Balance significantly improved after treatment with Todd-Davies method as compared to Margaret Johnstone method (p<0.05). A comparison of the Karnofsky Performance Scale scores of the patients with brain tumours showed that pre-and posttreatment scores more significantly differend in Johnstone treatment group than Todd-Davies group. Improvements in edama, pain sense and pathological reflexes were presented in percentages and the results were discussed. It was concluded that although both Todd-Davies and Margaret Johnstone neuropysiological methods are effective during acute hemiplegia rehabilitation, the success of the Margaret Johnstone method in acute stages is more significant (p<0.05).