Abstract
Modified constraint-induced movement therapy (CIMT) protocols show motor function and real-world arm use improvement. Meanwhile it usually requires constant supervision by physiotherapists and is therefore more expensive than customary care. This study compared the preliminary efficacy of two modified CIMT protocols. A two-group randomized controlled trial with pre and post treatment measures and six months follow-up was conducted. Nineteen patients with chronic stroke received 10 treatment sessions distributed three to four times a week over 22 days. CIMT3h_direct group received 3 hours of CIMT supervised by a therapist (n=10) while CIMT1.5h_direct group had 1.5 hours of supervised CIMT+1.5 hours home exercises supervised by a caregiver (n=9). Outcome measures were the Fugl-Meyer Assessment, the Motor Activity Log, and the Stroke Specific Quality of Life Scale. The modified CIMT protocols were feasible and well tolerated. Improvements in motor function, real-world arm use and quality of life did not differ significantly between treated groups receiving either 3 or 1.5 hours mCIMT supervised by a therapist.
Highlights
Materials and Methods Study design vise home exercises
Two days before treatment started, the caregiver was ia trained for one hour by the researcher providc ing CIMT on how to supervise the prescribed r exercises performed by the patient at home. e Each caregiver was instructed to make notes in a log book about the exercises performed, m the number of repetitions and difficulties experience by the patient
The FMA measures the level of motor impairment in stroke patients and has excellent improvement that was achieved during treatment.[34,35]
Summary
Inclusion criteria: age >18 years; history of ischemic or hemorrhagic stroke leading to upper limb paresis in the previous 24 months; minimal active range of motion of 10 degrees for wrist extension, 10 degrees for abduction/extension of the thumb and at least 2 additional digits, 90 degrees for shoulder flexion and abduction, 45 degrees for shoulder vised CIMT+1.5 hours home exercises super- tions were based on feasibility of supervised external rotation, 30 degrees for elbow extenvised by a caregiver (n=9). Activity Log, and the Stroke Specific Quality of beneficial to upper limb function in previous sion (from neutral), and finger extension of all. We hypothesized that Activity Log >2.5;9 balance and stability to motor function, real-world arm use and quality of life did not differ significantly between both programs would lead to comparable changes in motor outcomes and quality of life. Glove (with support of upper limbs, if necessary); availability of a family member to super-
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