EFFECTS OF CONSTRAINT- INDUCED MOVEMENT THERAPY (CIMT) ON IMPROVEMENT OF UPPER-LIMB AND HAND FUNCTION IN STROKE PATIENTS: AN INTEGRATIVE REVIEW

Abstract

Background and Aim: The aim of constraint-induced movement therapy (CIMT) is improving use of the upper limb that is functionally impaired after stroke. In CIMT to treat the use of upper limb impairment, application of the less severely affected arm is restricted for many hours each weekday over 2 consecutive weeks. The aim of this study was to investigate the effects of constraint-induced movement therapy on improvement of upper limb and hand function in stroke patients by integrative review of published articles since 2000- 2013. Materials and Methods: An integrative review of published articles regarding the effectiveness of constraint- induced movement therapy in promotion of hand function in stroke patients since 2000- 2013 was used in this study. We reviewed Iranian databases such as SID and MagIran and foreign databases such as Pedro, OT Bib Sys, OT seeker, OTD base, Sciencedirect, Pubmed, Elsevier. We used a qualitative approach for content analysis. Results: Over 268 papers were found regarding stroke and upper limb function, 200 articles of those used different ways to improve upper limb function, such as medication, physiotherapy, occupational therapy approaches and were rejected, the remained 68 articles were dedicated to the study of constraint- induced movement therapy. Among these articles, 43 papers were about the effects of constraint induced movement therapy on development of upper extremity. 9 articles were excluded due to using of Constraint Induced Movement Therapy on head injury patients and lab rat. Finally, 36 articles were selected according to the criteria of entry. Conclusion: The aggregate results of a review of studies showed that constraint induced movement therapy improves function of upper extremity at every stages of stroke (acute, sub acute and chronic) with a prerequisite of having active extension of wrist and finger, passive 90 ° flexion and abduction and 45°external rotation of the shoulder, 45° pronation and supination and having good cognitive function (MMSE =20 to 24). This method is more effective than traditional rehabilitation method in improving upper extremity functional abilities of stroke patients and overcoming the learned nonuse syndrome. But its impact on quality of life and movement kinematics requires further investigations. Key words: stroke, hand function, constraint-induced movement therapy, integrative review