title: Comparison of constraint-induced movement therapy and bilateral treatment of equal intensity in people with chronic upper-extremity dysfunction after cerebrovascular accident.
abstract: OBJECTIVE
  We compared the effectiveness of constraint-induced movement therapy (CIMT) with bilateral treatment of equal intensity for chronic upper-extremity (UE) dysfunction caused by cerebrovascular accident (CVA).
  
  
  METHODS
  We conducted a 2-group, randomized intervention trial with stratification by severity of UE dysfunction. Twelve community-dwelling adults were provided with 6 hr of occupational therapy for 10 days plus additional home practice. Six participants wore a mitt on the unimpaired UE, and 6 participants were intrusively and repetitively cued to use both UEs. The Wolf Motor Function Test (WMFT) and the Canadian Occupational Performance Measure (COPM) were administered before and after treatment and at 6-mo follow-up.
  
  
  RESULTS
  Significant improvements were found in WMFT and COPM scores across time in both groups. No significant between-group differences were found on the WMFT.
  
  
  CONCLUSIONS
  High-intensity occupational therapy using a CIMT or a bilateral approach can improve UE function in people with chronic UE dysfunction after CVA. Treatment intensity rather than restraint may be the critical therapeutic factor.
authors.affiliation: Occupational Therapy Department, Samuel Merritt University, Oakland, CA 94609, USA.
authors.forename: Kate
authors.initials: K
authors.lastname: Hayner
authors.forename: Ginny
authors.initials: G
authors.lastname: Gibson
authors.forename: Gordon Muir
authors.initials: GM
authors.lastname: Giles
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy / Q000379:methods*; D010291:Paresis / Q000209:etiology / Q000534:rehabilitation*; D020127:Recovery of Function; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D034941:Upper Extremity