Effect of Modified Constraint-Induced Movement Therapy on Upper Extremity Function for Stroke Patients with Right/Left Arm Paresis: A Single-Blind Randomized Controlled Trial

Abstract

Purpose: Stroke is one of the most common causes of disability because of functional, cognitive, and psychological issues. Motor deficits in the afflicted upper extremity affect about 50% of stroke survivors. This study aimed to evaluate the effects of modified constraint-induced movement therapy (mCIMT) on hemiparetic right/left upper limb functions and quality of life (QOL). Materials and Methods: In this prospective, randomized, controlled and single-blind study, 40 patients were assigned to the right-mCIMT (n=10), left-mCIMT (n=10), and control (n=20). mCIMT was applied 4h/day, 2 weeks, 10 sessions. A conventional rehabilitation program was applied to all patients. Patients were evaluated using the Fugl-Meyer Motor Assessment (FMA), Motor Activity Log (MAL), Stroke Impact Scale (SIS), Box-Block Test (BBT), the number of repetitions in shaping exercises, and the duration of task exercise. Results: There was a statistically significant improvement in the FMA of the left-mCIMT group (p=0.040). Both mCIMT groups showed statistically significant improvements in the MAL-amount of use (AoU) and MAL-quality of use (QoU), the number of repetitions in the shaping exercises, and the BBT (p<0.05). The activity of daily living, hand function, and stroke recovery domains of the SIS were increased significantly in both groups (p<0.01). There was a statistically significant increase in the strength domain of the SIS in the left-CIMT group (p=0.037). Conclusions: mCIMT was effective in improving motor functions, dexterity, and QOL in patients with right/left arm paresis. These positive effects continued for 3 months. Although left mCIMT had a positive effect on arm motor impairment, further research is needed.

Keywords

• constraint-induced movement therapy
• stroke
• rehabilitation
• upper limb
• quality of life