Modified constraint-induced therapy extension: using remote technologies to improve function.
OBJECTIVE
To determine efficacy of a modified constraint-induced therapy extension (mCITE) protocol, in which persons with stroke participated in therapy sessions via the Internet.


METHODS
Pre-post, single-blinded case series.


METHODS
Outpatient clinic.


METHODS
Four people with stroke who experienced stroke more than 1 year prior to study entry exhibiting upper-limb hemiparesis and nonuse.


METHODS
Subjects participated in online, 30-minute therapy sessions, 3 times a week for 10 weeks using personal computer-based cameras and free network meeting software. During the same period, subjects' less affected hands and wrists were restrained every weekday for 5 hours. Patients completed online logs to document restraint use and activities practiced at home.


METHODS
The Motor Activity Log (MAL) and Wolf Motor Function Test (WMFT). We also used a structured interview to ask patients about their satisfaction with the protocol.


RESULTS
After intervention, subjects exhibited marked improvements in more affected arm use (+2.7, +2.06, +1.7, +2,83, respectively), quality of movement (+2.1, +2.1, +2.03, +1.9, respectively), as measured by the MAL, and speed increases while performing WMFT tasks. Subjects' mCITE satisfaction and adherence were high, and motor changes translated to ability to perform valued activities.


CONCLUSIONS
A home-based, modified constraint-induced movement therapy program is feasible and appears to increase more affected arm use and function using commercially available, inexpensive technologies.
Page
Stephen J
SJ
Department of Physical Medicine and Rehabilitation, University of Cincinnati Academic Medical Center, Cincinnati, OH 45267, USA. Stephen.Page@uc.edu
Levine
Peter
P
D000203:Activities of Daily Living; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000503:physiopathology / Q000534:rehabilitation; D017060:Patient Satisfaction; D026741:Physical Therapy Modalities; D012149:Restraint, Physical; D016037:Single-Blind Method; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D017216:Telemedicine; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology