title: Feasibility of the modified constraint-induced movement therapy in patients with median and ulnar nerve injuries: a single-subject A-B-A design.
abstract: OBJECTIVE
  The present study aimed to determine feasibility and efficacy of the modified constraint-induced movement therapy on upper limb function in patients with median and ulnar nerve injuries.
  
  
  METHODS
  Single subject, A1-B-A2 design.
  
  
  METHODS
  Occupational therapy outpatient clinic.
  
  
  METHODS
  A convenience sample including three patients with median and ulnar nerve injuries.
  
  
  METHODS
  Modified constraint-induced movement therapy as follows: an intensive practice with affected hand for one hour daily, five days per week, for four weeks while the healthy hand was immobilised using a splint during waking hours.
  
  
  METHODS
  Semmes-Weinstein monofilaments, Box and block test, and Disabilities of the arm, shoulder, and hand questionnaire. A blinded assessor administered the assessments in a random order across sessions, six times for the baseline phase (A1), four times for the intervention phase (B), and four times for the withdrawal phase (A2).
  
  
  RESULTS
  Touch perception did not occur after the intervention phase at the pulp of the index and little fingers. Manual dexterity and motor ability significantly improved (Box and block change scores exceeded the minimal detectable change of 5.5 blocks), as well performance in activities of daily living during real life (Disabilities of the arm, shoulder, and hand questionnaire change scores exceeded the clinically important change value of 20.9 points). These improvements maintained and even enhanced during the withdrawal phase.
  
  
  CONCLUSIONS
  Modified constraint-induced movement therapy is a feasible and useful adjunct to rehabilitation of the patients with median and ulnar nerve injuries that warrants further research.
authors.affiliation: Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran hrr.rostami@gmail.com.
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Rostami
authors.affiliation: Department of Occupational Therapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Khayatzadeh Mahany
authors.affiliation: University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
authors.forename: Narjes
authors.initials: N
authors.lastname: Yarmohammadi
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000554:Ambulatory Care Facilities; D002908:Chronic Disease; D026241:Exercise Movement Techniques / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000293:injuries*; D009788:Occupational Therapy / Q000379:methods*; D017063:Outcome Assessment, Health Care; D012149:Restraint, Physical / Q000379:methods*; D016037:Single-Blind Method; D014459:Ulnar Nerve / Q000293:injuries*; D034941:Upper Extremity / Q000503:physiopathology*
keywords: Constraint-induced movement therapy; hand rehabilitation; median nerve injury; occupational therapy; ulnar nerve injury