Effect of constraint-induced movement therapy on improving the activities of daily living among stroke patients

Abstract

Objective To observe the effect of constraint-induced movement therapy (CIMT) on improving the activities of daily living (ADL) among stroke patients. Methods Thirty stroke patients who were hospitalized in Haining Kanghua Hospital during May 2012 to May 2014 were selected. Fifteen patients took only routine rehabilitation therapy (control group), while the other 15 patients took routine rehabilitation therapy plus CIMT (experimental group). All treatment plans were made according to patients’ conditions and willingness, for which informed consent forms were signed. The control group received routine therapy including proprioceptive neuromuscular facilitation, joint moving training, gaittraining, and therapeutic cexercises, whereas the experimental group received CIMT in addition to routine therapy (which manily including limit of usage of healthy side and strengthening of activities of affected sides, the intensive training including eating training, washing training, putting on and off upper garment training, putting on and off trousers training, using the toilet training, transferring bed and chair training and up and down toilet stool training). Both groups received treatments for 4 weeks, after which Fugl-Meyer Assessment(FMA) was implemented to assess their motor function and functional independence measurement(FIM) was used to assess patients’ ADL. For measurement data, paired t test was used for in-group comparison and independent t test was used for between-group comparison. For enumeration data, χ2test was used for comparison. Results The difference of the FMA scores of the two groups of patients had no statistical meaning before treatments (t=1.76,P>0.05). The difference of their FMA scores still had no statistical meaning after two weeks of treatments (t=2.01,P>0.05). After 3 and 4 weeks of treatments the FMA scores of the experimental group were significantly higher than the control group (64±22, 75±20 and 47±30, 55±28) and the difference had statistical meaning (t=8.32, 14.26, bothP 0.05). After treatment, both groups had increased scores for every item of the FIM (FIM scores of experimental group after the treatment were 5.5±0.6, 5.2±0.7, 5.3±0.6, 5.3±0.6, 5.1±1.0, 6.1±0.6, 5.8±0.7 respectively, FIM scores of control group after the treatment were 4.9±0.6, 4.7±0.7, 4.8±0.6, 4.7±0.6, 4.5±0.5, 5.5±0.5, 4.8±0.7 respectively), and the difference had statistical meaning (t=17.49, 10.64, 14.49, 11.30, 9.37, 11.12, 9.89, and 6.86, 9.03, 11.23, 9.03, 10.25, 12.22, 9.03, allP<0.05). Compared to the control group, the experimental group all had significantly higher FIM scores, and the difference had statistical meaning (t=2.57, 2.09, 2.48, 2.46, and 2.08, 2.95, 4.05, all P<0.05). Conclusion CIMT can significantly improve ADL for stroke patients and further improve their life quality. Key words: Movement therapy, mandatory plan; Stroke; Hemiplegic; Activities of daily living