title: Efficacy of Modified Constraint Induced Movement Therapy in the Treatment of Hemiparetic Upper Limb in Stroke Patients: A Randomized Controlled Trial.
abstract: BACKGROUND
  Paretic upper limb in stroke patients has a significant impact on the quality of life. Modified Constraint Induced Movement Therapy (mCIMT) is one of the treatment options used for the improvement of the function of the paretic limb.
  
  
  OBJECTIVE
  To investigate the efficacy of four week duration mCIMT in the management of upper extremity weakness in hemiparetic patients due to stroke.
  
  
  METHODS
  Prospective single blind, parallel randomized controlled trial in which 30 patients received conventional rehabilitation programme (control group) and 30 patients participated in a mCIMT programme in addition to the conventional rehabilitation programme (study group). The mCIMT included three hours therapy sessions emphasizing the affected arm use in general functional tasks, three times a week for four weeks. Their normal arm was also constrained for five hours per day over five days per week. All the patients were assessed at baseline, one month and three months after completion of therapy using Fugl-Meyer Assessment (FMA) score for upper extremity and Motor Activity Log (MAL) scale comprising of Amount of Use (AOU) score and Quality of Use (QOU) score.
  
  
  RESULTS
  All the 3 scores improved significantly in both the groups at each follow-up. Post-hoc analysis revealed that compared to conventional rehabilitation group, mCIMT group showed significantly better scores at 1 month {FMA1 (p-value <0.0001, es0.2870), AOU1 (p-value 0.0007, es0.1830), QOU1 (p-value 0.0015, es0.1640)} and 3 months {FMA3 (p-value <.0001, es0.4240), AOU3 (p-value 0.0003, es 0.2030), QOU3 (p-value 0.0008, es 0.1790)}.
  
  
  CONCLUSIONS
  Four weeks duration for mCIMT is effective in improving the motor function in paretic upper limb of stroke patients.
authors.affiliation: Senior Resident, Department of Physical Medicine & Rehabilitation, VMMC & Safdarjung Hospital , New Delhi, India .
authors.forename: Raj Kumar
authors.initials: RK
authors.lastname: Yadav
authors.affiliation: Director, AIIPMR , Mumbai, Maharashtra, India .
authors.forename: Rajendra
authors.initials: R
authors.lastname: Sharma
authors.affiliation: Professor, Department of Physical Medicine & Rehabilitation, VMMC & Safdarjung Hospital , New Delhi, India .
authors.forename: Diganta
authors.initials: D
authors.lastname: Borah
authors.affiliation: Retired Special DGHS and Professor, Department of Physical Medicine & Rehabilitation, VMMC & Safdarjung Hospital , New Delhi, India .
authors.forename: S Y
authors.initials: SY
authors.lastname: Kothari
keywords: Functional outcome; Rehabilitation; Upper extremity function