title: The EXCITE Trial: Predicting a clinically meaningful motor activity log outcome.
abstract: OBJECTIVE
  This study determined which baseline clinical measurements best predicted a predefined clinically meaningful outcome on the Motor Activity Log (MAL) and developed a predictive multivariate model to determine outcome after 2 weeks of constraint-induced movement therapy (CIMT) and 12 months later using the database from participants in the Extremity Constraint Induced Therapy Evaluation (EXCITE) Trial.
  
  
  METHODS
  A clinically meaningful CIMT outcome was defined as achieving higher than 3 on the MAL Quality of Movement (QOM) scale. Predictive variables included baseline MAL, Wolf Motor Function Test (WMFT), the sensory and motor portion of the Fugl-Meyer Assessment (FMA), spasticity, visual perception, age, gender, type of stroke, concordance, and time after stroke. Significant predictors identified by univariate analysis were used to develop the multivariate model. Predictive equations were generated and odds ratios for predictors were calculated from the multivariate model.
  
  
  RESULTS
  Pretreatment motor function measured by MAL QOM, WMFT, and FMA were significantly associated with outcome immediately after CIMT. Pretreatment MAL QOM, WMFT, proprioception, and age were significantly associated with outcome after 12 months. Each unit of higher pretreatment MAL QOM score and each unit of faster pretreatment WMFT log mean time improved the probability of achieving a clinically meaningful outcome by 7 and 3 times at posttreatment, and 5 and 2 times after 12 months, respectively. Patients with impaired proprioception had a 20% probability of achieving a clinically meaningful outcome compared with those with intact proprioception.
  
  
  CONCLUSIONS
  Baseline clinical measures of motor and sensory function can be used to predict a clinically meaningful outcome after CIMT.
authors.affiliation: Department of Stroke Rehabilitation, National Rehabilitation Center, Seoul, Korea. seanpark05@yahoo.co.kr
authors.forename: Si-Woon
authors.initials: SW
authors.lastname: Park
authors.forename: Steven L
authors.initials: SL
authors.lastname: Wolf
authors.forename: Sarah
authors.initials: S
authors.lastname: Blanton
authors.forename: Carolee
authors.initials: C
authors.lastname: Winstein
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Nichols-Larsen
mesh_terms: D000368:Aged; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008959:Models, Neurological; D009043:Motor Activity / Q000502:physiology*; D010291:Paresis / Q000209:etiology / Q000503:physiopathology* / Q000534:rehabilitation*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D013997:Time Factors; D016896:Treatment Outcome; D034941:Upper Extremity
references.citation: Stroke. 2004 Jun;35(6):1410-4
references.pmid: 15087552
references.citation: NeuroRehabilitation. 2006;21(2):97-105
references.pmid: 16917157
references.citation: Science. 1991 Jun 28;252(5014):1857-60
references.pmid: 1843843
references.citation: J Rehabil Res Dev. 1999 Jul;36(3):237-51
references.pmid: 10659807
references.citation: Stroke. 2001 Jul;32(7):1635-9
references.pmid: 11441212
references.citation: Neurorehabil Neural Repair. 2003 Sep;17(3):137-52
references.pmid: 14503435
references.citation: Neurology. 2006 Oct 10;67(7):1189-94
references.pmid: 17030751
references.citation: Stroke. 2005 Jun;36(6):1172-7
references.pmid: 15890987
references.citation: Physiother Res Int. 2000;5(1):1-18
references.pmid: 10785907
references.citation: Stroke. 2005 Nov;36(11):2493-6
references.pmid: 16224078
references.citation: Cogn Behav Neurol. 2006 Mar;19(1):48-54
references.pmid: 16633019
references.citation: Neurorehabil Neural Repair. 2005 Sep;19(3):238-49
references.pmid: 16093415
references.citation: Phys Ther. 2006 Jun;86(6):825-32
references.pmid: 16737408
references.citation: Scand J Rehabil Med. 1994 Sep;26(3):115-9
references.pmid: 7801060
references.citation: Arch Phys Med Rehabil. 1979 Jan;60(1):14-7
references.pmid: 420565
references.citation: JAMA. 2006 Nov 1;296(17):2095-104
references.pmid: 17077374
references.citation: Stroke. 1999 Nov;30(11):2369-75
references.pmid: 10548673
references.citation: Phys Ther. 2007 Feb;87(2):170-8
references.pmid: 17244694
references.citation: Neurologist. 2002 Nov;8(6):325-38
references.pmid: 12801434