Effect of Modified Constraint-Induced Movement Therapy Combined with Auditory Feedback for Trunk Control on Upper Extremity in Subacute Stroke Patients with Moderate Impairment: Randomized Controlled Pilot Trial

Abstract

The trunk compensatory strategy can impede the longer term functional recovery of the upper extremity (UE). The objective of this study is to investigate the effects of modified constraint-induced movement therapy (mCIMT) combined with auditory feedback for trunk control on UE function and activities of daily living among subacute stroke patients with moderate impairment. Twenty participants with hemiparesis were randomly assigned to either the mCIMT combined with auditory feedback group (n = 10) or the control group (n = 10). The mCIMT combined with auditory feedback group received the mCIMT protocol training at the same time as the auditory feedback for control of the compensatory movement of the trunk. The control group only received the mCIMT protocol. Each group underwent 20 (1 hour/day) intervention sessions (5 days/week for 4 weeks). The mCIMT combined with auditory feedback group exhibited greater changes in the Action Research Arm Test (P = .027; 95% CI .429-6.171), Fugl-Meyer Assessment upper extremity (P = .034; 95% CI .360-8.039), modified Barthel Index (P = .003; 95% CI 3.465-14.536), and amount of use of motor activity log (P = .009; 95% CI .078-.476) compared to the control group. There were no significant differences in the quality of movement (P = .054, 95% CI -.005 to .457) and modified Ashworth Scale (P = .288; 95% CI -.583 to .183) grades between the 2 groups. These findings suggest that mCIMT combined with auditory feedback for trunk control is more helpful in improving the UE function than mCIMT alone in subacute stroke patients with moderate impairment.