Feasibility of high repetition of task practice in constraint induced movement therapy in an acute stroke patient

Abstract

Background: Constraint induced movement therapy (CIMT) is a rehabilitation technique that has been reported to improve upper limb motor function. Its main components are constraint of the unaffected limb and task practice with the affected limb for specific periods of time. However, the optimal dose of task practice and its safety during acute stroke is not clear. This is because studies use different durations for task practice, and task practice during acute stroke in animals was reported to result in lesional expansion and subsequent functional deterioration. In animal models and human chronic stroke patients, high repetitions of task practice of ranging from 300–800 has been reported to be the number required for functional improvement. Whether this is possible in acute stroke is not clear. Aim: The aim of this case report was to investigate the feasibility of 320 repetitions of task practice during CIMT in a patient who had a stroke 8 days prior to the commencement of treatment. Method: The patient was a 55-year-old woman who was 8 days post stroke at the time of treatment commencement, with mild left upper limb motor impairment. The patient performed 320 repetitions of functional tasks divided between two sessions per day, 5 days a week, for a duration of 8 weeks. Result: The results showed a significant improvement in upper limb motor function at 2 weeks, which reached the level of minimally clinical important difference (MCID) at 4, 6 and 8 weeks post-intervention. Conclusion: It may be possible to administer high repetitions of task practice to acute stroke patients.