Modified constraint-induced therapy in subacute stroke: a case report.
OBJECTIVE
To determine the efficacy of a modified constraint-induced therapy (CIT) protocol administered to a patient with subacute stroke.


METHODS
Multiple-baseline, before-after trial.


METHODS
Subacute outpatient clinic.


METHODS
A 68-year-old woman who had a left anterior cerebral artery infarct 5 months before study entry and who exhibited learned nonuse of the affected upper limb.


METHODS
Thirty minutes of structured physical therapy and 30 minutes of occupational therapy 3 times a week for 10 weeks, each session emphasizing affected arm use. During the same period, her unaffected arm and hand were restrained 5d/wk during 5 hours initially identified as a time of frequent use.


METHODS
The Fugl-Meyer Assessment of Motor Recovery (FMA), Action Research Arm Test (ARA), Wolf Motor Function Test (WMFT), and Motor Activity Log (MAL).


RESULTS
The patient exhibited substantial improvements on the FMA and ARA. She also improved on the WMFT in her ability to perform tasks and in the time taken to complete the tasks. Amount and quality of arm use also improved, as measured by the MAL.


CONCLUSIONS
Modified CIT may be an efficacious method of improving function and use of the affected arms of patients with learned nonuse.
Page
Stephen J
SJ
Kessler Medical Rehabilitation Research & Education Corp, West Orange, NJ 07052, USA.
Sisto
SueAnn
S
Johnston
Mark V
MV
Levine
Peter
P
Hughes
Mary
M
D000203:Activities of Daily Living; D000368:Aged; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D010291:Paresis / Q000534:rehabilitation*; D012149:Restraint, Physical; D000071939:Stroke Rehabilitation