Constraint induced movement therapy for stroke survivors in Jordon: a home-based model

Abstract

Aims: This article describes a home-based study evaluating the effectiveness of modified constraint induced movement therapy (CIMT) in improving upper limb function in stroke survivors, and compares it with the clinical-based Neurodevelopmental Treatment (NDT) approach. Methods: In this pretest-post-test randomized study, 10 stroke survivors received home-based modified CIMT and eight stroke survivors received conventional NDT rehabilitation. The focus of the CIMT was on the hemiplegic hand, by which the less affected hand was restrained, with structured training for the more affected arm and hand. The intervention was executed two hours a day, seven days a week for two months, in the patients' normal day-care environment. Arm motor function outcomes were evaluated using the Wolf Motor Function Test as a primary outcome measure. The motor activity log, and the Fugl-Meyer Assessment were used as secondary outcome measures. Findings: Stroke survivors in the CIMT group showed a statistically significant improvement in all arm motor function outcomes. However, while numerically the improvement was better in the CIMT group, it failed to be significantly better than that seen in the NDT group. Conclusions: Home based CIMT conducted by caregivers with therapists' support is a promising approach for improving affected upper limb in stroke survivors. However, additional studies are needed to confirm these findings.