title: Home forced use in an outpatient rehabilitation program for adults with hemiplegia: a pilot study.
abstract: The objective of this study was to examine the effectiveness of a program of traditional outpatient neurological rehabilitation that included home forced use. In total, 17 patients with chronic stroke and 1 patient with subacute stroke (mean time poststroke = 27.6 months) completed an individualized program consisting of seven 2-hour treatment sessions composed of 1 hour of occupational therapy and 1 hour of physical therapy. Therapy sessions were completed over a 2- to 3-week period and included instruction on the use of a restraining mitt at home during functional activities. The Wolf Motor Function Test (WMFT) was used to assess upper extremity impairment and function at baseline, midway through treatment, and posttreatment. Patients demonstrated statistically significant improvements (P < 0.05 corrected for multiple comparisons) in mean time for completion in 12 of 17 WMFT subtasks when comparing baseline to posttreatment. The preliminary results suggest that the forced-use component of constraint-induced therapy may be effective when applied within a traditional outpatient rehabilitation program. However, additional investigation is required to examine the effectiveness of using forced use within typical outpatient rehabilitation under more experimentally controlled conditions.
authors.affiliation: MossRehab Hospital, Philadelphia, Pennsylvania, USA. spierce@shrinenet.org
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Pierce
authors.forename: Kara G
authors.initials: KG
authors.lastname: Gallagher
authors.forename: Susan W
authors.initials: SW
authors.lastname: Schaumburg
authors.forename: Arthur M
authors.initials: AM
authors.lastname: Gershkoff
authors.forename: John P
authors.initials: JP
authors.lastname: Gaughan
authors.forename: Lori
authors.initials: L
authors.lastname: Shutter
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000458:organization & administration*; D005260:Female; D006429:Hemiplegia / Q000628:therapy*; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009788:Occupational Therapy; D026741:Physical Therapy Modalities; D010865:Pilot Projects; D015397:Program Evaluation; D012046:Rehabilitation / Q000458:organization & administration*