Stroke patients' and therapists' opinions of constraint-induced movement therapy (original) (raw)
Related papers
A meta-analysis of constraint-induced movement therapy after stroke
Journal of rehabilitation medicine, 2014
To evaluate the effect of constraint-induced movement therapy in adult stroke patients and to examine the impact of time since stroke and various treatment modalities. PubMed, EMBASE, Cochrane and PEDro trial registers were searched for clinical trials published before November 2012. Randomized or quasi-randomized controlled trials of constraint-induced movement therapy lasting 2-7 h/day for 8-28 days were included. Measurements were classified into the following categories: arm motor function, arm motor activity, activities of daily living, and participation. A pooled standardized mean difference (SMD) was calculated for each category. Moderators were: trial quality, behavioural techniques, amount of training, time since stroke, shaping, and the nature of the control group. Of 3842 records initially screened 23 trials were included. A small post-treatment effect was found on arm motor function (SMD 0.28, 95% confidence interval (CI) 0.11-0.44). Meanwhile, a moderate effect on arm m...
Clinical Rehabilitation, 2012
Objective: To examine the effect of constraint-induced movement therapy and modified constraintinduced movement therapy on activity and participation of patients with stroke (i.e. the effect of different treatment durations and frequency) by reviewing the results of randomized controlled trials. Data sources: A systematic literature search was conducted in MEDLINE, CINAHL, EMBASE, PEDro, OTSeeker, CENTRAL and by manual search. Review methods: Randomized controlled trials for patients over 18 years old with stroke and published in Finnish, Swedish, English or German were included. Studies were collected up to the first week in May 2011. The evidence was high, moderate, low or no evidence according to the quality of randomized controlled trial and the results of meta-analyses. Results: Search resulted in 30 papers reporting constraint-induced movement therapy, including 27 randomized controlled trials published between 2001 and 2011. Constraint-induced movement therapy practice for 60-72 hours over two weeks produced better mobility (i.e. ability to carry, move and handle objects) with high evidence compared to control treatment. Constraint-induced movement therapy for 20-56 hours over two weeks, 30 hours over three weeks and 15-30 hours over 10 weeks improved mobility of the affected upper extremity. However, with self-care as an outcome measure, only 30 hours of constraint-induced movement therapy practice over three weeks demonstrated an improvement.
2013
Constraint-induced movement therapy (CIMT) is a commonly used rehabilitation intervention to improve upper limb function after stroke. CIMT was originally developed for patients with a chronic upper limb paresis. Although there are indications that exercise interventions should start as early as possible after stroke, only a few randomized controlled trials have been published on either CIMT or modified forms of CIMT (mCIMT) during the acute phase after stroke. The implementation of (m)CIMT in published studies is very heterogeneous in terms of content, timing and intensity of therapy. Moreover, mCIMT studies often fail to provide a detailed description of the protocol applied. The purpose of the present paper is therefore to describe the essential elements of the mCIMT protocol as developed for the EXplaining PLastICITy after stroke (EXPLICIT-stroke) study. The EXPLICIT-stroke mCIMT protocol emphasizes restoring body functions, while preventing the development of compensatory movement strategies. More specifically, the intervention aims to improve active wrist -and finger extension, which is assumed to be a key factor for upper limb function. The intervention starts within 2 weeks after stroke onset. The protocol retains two of the three key elements of the original CIMT protocol, that is, repetitive training and the constraining element. Repetitive task training is applied for 1 hour per working day, and the patients wear a mitt for at least 3 hours per day for three consecutive weeks.
International Journal of Physical Medicine & Rehabilitation, 2014
Background: The protocols of constraint induced movement therapy are heterogeneous, and it is difficult to adopt one particular protocol. Aim: The aim of this study was to evaluate the efficacy of a standardized constrain induced movement therapy protocol where all the participants will perform same tasks and with same number of repetitions. Methods: Sixteen stroke patients (6 males, 10 females, with mean age 53.71 years) who were < 6 months poststroke were randomized into experimental and control groups. The experimental and control groups received standardized CIMT and traditional modified CIMT respectively for 4 weeks. Motor function was assessed at baseline, 2 and 4 weeks post-intervention using WMFT and MAL. The data was analyzed using t-test, one-way repeated measures ANOVA and one-way ANCOVA. Result: A significant difference was recorded using one way repeated ANOVA in the control group between baseline, and 2 weeks; and 4 weeks post-intervention(Wilk's Lambda = 0.29, p= 0.025) for both AOU, QOU and WMFT. The results recorded using t-test and one-way ANCOVA showed no significant difference between groups. However, there was a strong relationship that existed on the effect of covariate (baseline) on the 2 and 4 weeks post-intervention scores as indicated by large eta squared values. Conclusion: It is possible for stroke patients to perform 320 repetitions of tasks practice (same tasks) per day.
Physical Therapy, 2016
Background and Purpose. Limited evidence exists regarding the characteristics of people who benefit most from constraint-induced movement therapy (CIMT). This study’s purpose was to investigate 6 potential descriptors in predicting CIMT outcomes. Subjects. The participants were a convenience sample (N=55) of people who were more than 6 months poststroke. Methods. The Wolf Motor Function Test (WMFT) and the Motor Activity Log amount scale (MALa) were used to assess outcomes for CIMT. The potential predictors (side of stroke, time since stroke, hand dominance, age, sex, and ambulatory status) were entered into a linear regression model using stepwise entry, with simultaneous entry of the dependent variables’ pretest scores as the covariate. Results. Age was the only significant predictor of the 6 potential predictors in the model and was predictive only of MALa scores. None of the independent variables showed a predictive relationship with the WMFT. Discussion and Conclusion. Although...