A randomized controlled trial of constraint-induced movement therapy after stroke

To evaluate the benefits of constraint-induced movement therapy (CIMT) relative to traditional intervention equal in treatment intensity and use of restraint mitt outside rehabilitation on motor performance and daily functions in stroke patients. Design. Two-group randomized controlled trial (RCT). Setting. Rehabilitation clinics. Subjects. Twenty-two chronic stroke patients (mean time postonset of stroke = 18.9 months). The subjects were randomized to receive CIMT (restraint of the less affected limb combined with intensive training of the affected limb) or traditional intervention (control treatment) during the study. The treatment intensity was matched between the two groups (2h/d, 5d/wk for 3 wk). Both groups of patients received restraint of the less affected limb outside rehabilitation (ca. 3h/d). Motor performance was evaluated using the Fugl-Myer Assessment and the Motor Activity Log. Functional outcomes were evaluated using the Functional Independence Measure and the Nottingham extended activities of daily living scale. The CIMT group showed significantly greater improvements in motor performance, level of functional independence, and the mobility domain of extended activities of daily living. Conclusions. This is the first RCT to show the benefits of CIMT, relative to control treatment equal in amount of therapy, in improving motor performance and some aspects of basic and extended activities of daily living.