Efficacy of Constraint-Induced Movement Therapy in Early Stroke Rehabilitation: A Randomized Controlled Multisite Trial.
BACKGROUND
There is limited evidence for the effects of constraint-induced movement therapy (CIMT) in the early stages of stroke recovery.


OBJECTIVE
To evaluate the effect of a modified CIMT within 4 weeks poststroke.


METHODS
This single-blinded randomized multisite trial investigated the effects of CIMT in 47 individuals who had experienced a stroke in the preceding 26 days. Patients were allocated to a CIMT or a usual care (control) group. The CIMT program was 3 h/d over 10 consecutive working days, with mitt use on the unaffected arm for up to 90% of waking hours. The follow-up time was 6 months. The primary outcome was the Wolf Motor Function test (WMFT) score. Secondary outcomes were the Fugl-Meyer upper-extremity motor score, Nine-Hole Peg test (NHPT) score, the arm use ratio, and the Stroke Impact Scale. Analyses of covariance with adjustment for baseline values were used to assess differences between the groups.


RESULTS
After treatment, the mean timed WMFT score was significantly better in the CIMT group compared with the control group. Moreover, posttreatment dexterity, as tested with the NHPT, was significantly better in the CIMT group, whereas the other test results were similar in both the groups. At the 6-month follow-up, the 2 groups showed no significant difference in arm impairment, function, or use in daily activities.


CONCLUSIONS
Despite a favorable effect of CIMT on timed movement measures immediately after treatment, significant effects were not found after 6 months.
UiT The Arctic University of Norway, Tromsø, Norway University Hospital of North Norway, Tromsø, Norway gyrd.thrane@uit.no.
Gyrd
G
Thrane
Norwegian University of Science and Technology, Trondheim, Norway Sør-Trøndelag University College, Trondheim, Norway.
Torunn
T
Askim
Trondheim University Hospital, Norway.
Roland
R
Stock
Trondheim University Hospital, Norway.
Bent
B
Indredavik
Vestfold Hospital Trust, Norway.
Ragna
R
Gjone
Oslo University Hospital, Norway.
Anne
A
Erichsen
UiT The Arctic University of Norway, Tromsø, Norway University Hospital of North Norway, Tromsø, Norway.
Audny
A
Anke
D000203:Activities of Daily Living; D000208:Acute Disease; D000368:Aged; D001132:Arm / Q000503:physiopathology; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement; D009664:Norway; D012720:Severity of Illness Index; D016037:Single-Blind Method; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
constraint-induced movement therapy; rehabilitation; stroke