Influences of hand dominance on the maintenance of benefits after home-based modified constraint-induced movement therapy in individuals with stroke.
OBJECTIVE
To investigate the influence of hand dominance on the maintenance of gains after home-based modified constraint-induced movement therapy (mCIMT).


METHODS
Aprevious randomized controlled trial was conducted to examine the addition of trunk restraint to the mCIMT. Twenty-two chronic stroke survivors with mild to moderate motor impairments received individual home-based mCIMT with or without trunk restraints, five times per week, three hours daily over two weeks. In this study, the participants were separated into dominant group, which had their paretic upper limb as dominant before the stroke (n=8), and non-dominant group (n=14) for analyses. The ability to perform unimanual tasks was measured by the Wolf Motor Function Test (WMFT) and the Motor Activity Log (MAL), whereas the capacity to perform bimanual tasks was measured using the Bilateral Activity Assessment Scale (BAAS).


RESULTS
Analysis revealed significant positive effects on the MAL amount of use and quality of the movement scales, as well as on the BAAS scores after intervention, with no differences between groups. Both groups maintained the bimanual improvements during follow-ups (BAAS-seconds 0.1, 95% CI -10.0 to 10.0), however only the dominant group maintained the unilateral improvements (MAL-amount of use: 1.5, 95% CI 0.7 to 2.3; MAL-quality: 1.3, 95% CI 0.5 to 2.1).


CONCLUSIONS
Upper limb dominance did not interfere with the acquisition of upper limb skills after mCIMT. However, the participants whose paretic upper limb was dominant demonstrated better abilities to maintain the unilateral gains. The bilateral improvements were maintained, regardless of upper limb dominance.
Departamento de Fisioterapia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
Renata C M
RC
Lima
Departamento de Fisioterapia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
Lucas R
LR
Nascimento
Departamento de Fisioterapia, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brasil.
Stella M
SM
Michaelsen
Departamento de Fisioterapia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
Janaine C
JC
Polese
Departamento de Fisioterapia, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brasil.
Natália D
ND
Pereira
Departamento de Fisioterapia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
Luci F
LF
Teixeira-Salmela
D005081:Exercise Therapy; D005260:Female; D007839:Functional Laterality; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D016037:Single-Blind Method; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation / Q000379:methods*; D034941:Upper Extremity / Q000503:physiopathology*