Abstract
Background: Constraint induced movement therapy (CIMT) is effective at improving upper limb outcomes after stroke.Aim: The aim of this study was to carry out a systematic review and meta-analysis of the effects of lower limb CIMT studies of any design in people with stroke.Materials/ Method: PubMED, PEDro, OTSeeker, CENTRAL, and Web of Science were searched from their earliest dates to February 2021. Lower limbs CIMT studies that measured outcomes at baseline and post-intervention were selected. Sample size, mean, and standard deviation on the outcomes of interest and the protocols of both the experimental and control groups were extracted. McMaster Critical Review Form was used to assess the methodological quality of the studies.Result: Sixteen studies with different designs were included in this review. The result showed that lower limb CIMT improves functional, physiological and person's reported outcomes including motor function, balance, mobility, gait speed, oxygen uptake, exertion before and after commencement of activities, knee extensor spasticity, weight bearing, lower limb kinematics and quality of life in people with stroke post intervention. However, there were only significant differences in quality of life in favor of CIMT post-intervention [mean difference (MD) = 16.20, 95% CI = 3.30–29.10, p = 0.01]; and at follow-up [mean difference (MD) = 14.10, 95% CI = 2.07–26.13, p = 0.02] between CIMT and the control group. Even for the quality of life, there was significant heterogeneity in the studies post intervention (I2 = 84%, p = 0.01).Conclusion: Lower limb CIMT improves motor function, balance, functional mobility, gait speed, oxygen uptake, weigh bearing, lower limb kinematics, and quality of life. However, it is only superior to the control at improving quality of life after stroke based on the current literature.
Highlights
Constraint Induced Movement Therapy (CIMT) is a translational motor rehabilitation technique following injury of the Central Nervous System (CNS)
Heterogeneity between studies was considered substantial only when I2 value is ≥50%
To achieve recovery of function during the chronic stage of stroke, motor rehabilitation techniques such as CIMT may need to be combined with sensorimotor stimulation techniques such as transcortical direct stimulation and trans-magnetic stimulation (TMS) (44)
Summary
Constraint Induced Movement Therapy (CIMT) is a translational motor rehabilitation technique following injury of the Central Nervous System (CNS). The technique originated many decades ago from use in primates; and was translated to humans following stroke and other neurological conditions (1). The original concept involved constraint of the unaffected limb and forced use of the affected one (2). Subsequent studies in humans involved voluntary massed tasks or shaping practices with the affected limb. There have been many modifications over the years of the original protocol of CIMT, including but not limited to the length of time for the tasks practice, the constraint, and the use of a transfer package (7–9). Constraint induced movement therapy (CIMT) is effective at improving upper limb outcomes after stroke
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
