Effectiveness of constraint-induced movement therapy (CIMT) as home-based therapy on Barthel Index in patients with chronic stroke.
OBJECTIVE
The goal of this study is to investigate the effectiveness of constraint-induced movement therapy (CIMT) on the Barthel Index (BI) scores in persons with stroke to assess dependency in survivers of stroke and to investigate the long-term effects of CIMT on dependency needs as measured by the BI, based on the hypothesis that CIMT as home-based therapy would be of significant benefit in stroke rehabilitation.


METHODS
Twenty-seven participants, 16 men with a mean age of 58 (+/- 10.8) and 4 women with a mean age of 60 (+/- 6.3), participated in the study as an experimental group, and 17 participants, 12 men with a mean age of 58 (+/- 9.7) and 5 women with a mean age of 55 (+/-11.8), participated as a control group. The experimental/treatment group received traditional therapy with the CIMT where the intact contralateral upper limb was placed in a removable cast for 6 hours a day during waking hours for 4 weeks. The control group received traditional therapy only. Both groups were assessed using the BI on admission and on discharge from rehabilitation. In addition, 18 participants (14 male and 4 female), 64% of the experimental group, were reevaluated using the BI for the long-term benefits of CIMT on dependency.


RESULTS
Using unpaired t test (SPSS version 15), statistically significant improvement was noted in the BI for the experimental group compared to the control group. After 6 months follow-up, BI was 96.3 +/- 2.7, indicating that the obtained gains were maintained at 6 months post discharge, compared to their BI score at 4 weeks (68.2 +/- 3.8) post CIMT (p value < .005).


CONCLUSIONS
Following stroke, patients who received CIMT every day for 4 weeks in conjunction with traditional rehabilitation therapy showed significant changes in the BI upon discharge and this positive outcome was preserved after 6 months follow-up. This improvement indicates an overall significant improvement in ADL status for patients who received CIMT and has implications for future use in stroke rehabilitation as home-based therapy for stroke rehabilitation.
Azab
Mohammed
M
Department of Toxicology and Forensic Sciences, Faculty of Medicine, Jordan University of Science and Technology (JUST), Irbid, Jordan.
Al-Jarrah
Muhammed
M
Nazzal
Mahmoud
M
Maayah
Mikhled
M
Sammour
Mohammed Abu
MA
Jamous
Mohammed
M
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D020127:Recovery of Function; D012149:Restraint, Physical; D012648:Self Care; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome