Constraint-induced movement therapy and rehabilitation exercises lessen motor deficits and volume of brain injury after striatal hemorrhagic stroke in rats.
OBJECTIVE
Constraint-induced movement therapy (CIMT) promotes motor recovery after occlusive stroke in humans, but its efficacy after intracerebral hemorrhage (ICH) has not been investigated clinically or in the laboratory. In this study we tested whether CIMT and a rehabilitation exercise program would lessen motor deficits after ICH in rats.


METHODS
Rats were subjected to striatal ICH (via infusion of collagenase) or sham stroke. Seven days later, treatment began with CIMT (8 h/d of ipsilateral forelimb restraint), rehabilitation exercises (eg, reaching, walking; 1 h/d), or both for 7 days. Some rats were not treated. Motor deficits were assessed up to the 60-day survival time, after which the volume of tissue lost was determined.


RESULTS
Untreated ICH rats made more limb slips traversing a horizontal ladder and showed an asymmetry toward less use of the contralateral paw in the cylinder test of limb use asymmetry (day 28). These rats were also significantly less successful in the Montoya staircase test (days 55 to 59) of skilled reaching. Neither therapy alone provided much benefit. However, the combination of daily exercises and CIMT substantially and persistently improved recovery. Unexpectedly, this group had a statistically smaller volume of tissue lost than untreated ICH rats.


CONCLUSIONS
The combination of focused rehabilitation exercises and CIMT effectively promotes functional recovery after ICH, while either therapy alone is less effective. This therapy may work in part by reducing the volume of tissue lost, likely through reducing atrophy while promoting remodeling.
DeBow
Suzanne B
SB
Department of Psychology, Center for Neuroscience, University of Alberta, Edmonton, Alberta, Canada.
Davies
Melissa L A
ML
Clarke
Heather L
HL
Colbourne
Frederick
F
D000818:Animals; D001522:Behavior, Animal; D001921:Brain / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000473:pathology / Q000534:rehabilitation / Q000628:therapy*; D003131:Combined Modality Therapy; D003342:Corpus Striatum; D005081:Exercise Therapy / Q000379:methods*; D007103:Immobilization; D008297:Male; D019957:Motor Skills Disorders / Q000534:rehabilitation / Q000628:therapy*; D009068:Movement; D051381:Rats; D017207:Rats, Sprague-Dawley; D020521:Stroke / Q000473:pathology / Q000628:therapy*; D000071939:Stroke Rehabilitation