Case report: a modified constraint-induced therapy (mCIT) program for the upper extremity of a person with chronic stroke.
The purpose of this case report was to assess the effect of a reduced intensity protocol for daily modified constraint-induced therapy (mCIT) without use of a restraint on the function of the upper extremity (UE) in an individual with a chronic stroke. A 57 year-old patient one year following a stroke participated in a two-hour mCITprogram for ten weekdays over a period of two weeks. During this period, voluntary use of the involved extremity was encouraged for 90% of waking hours at home without use of a restraint. Examination was conducted before and after intervention, and at a one month follow-up visit. Outcome measures included: the Wolf Motor Function Test (WMFT), the Motor Activity Log (MAL), and motion analysis of a reach and grasp task using Charnwood's CODA mpx 30. The patient improved or remained the same in functional upper extremity tasks on both the WMFT and MAL. The data from the motion analysis showed that grasp time and maximum pinch angle improved for bilateral UEs. Reaching profile graphed over time had fewer changes in velocity and fewer periods of acceleration and deceleration post-intervention. This reduced intensity program shows promise as an effective, feasible, and patient-preferred application of mCIT in a clinical setting.
Hakim
Renée M
RM
Department of Physical Therapy, University of Scranton, 800 Linden Street, Scranton, PA, 18510, USA. hakimr2@scranton.edu
Kelly
Stephen J
SJ
Grant-Beuttler
Marybeth
M
Healy
Brian
B
Krempasky
Jesse
J
Moore
Sean
S
D005260:Female; D018737:Hand Strength; D006801:Humans; D008875:Middle Aged; D009048:Motor Skills / Q000502:physiology; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D026741:Physical Therapy Modalities; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D034941:Upper Extremity / Q000503:physiopathology*