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A study of constraint-induced movement therapy in subacute stroke patients in Hong Kong
Myint JMWW, Yuen GFC, Yu TKK, Kng CPL, Wong AMY, Chow KKC, Li HCK, Wong CP
Clinical Rehabilitation 2008 Feb;22(2):112-124
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To the beneficial effect of constraint-induced movement investigate therapy in improving the function of hemiplegic upper extremity in the early subacute stroke patients. DESIGN: A prospective, single-blinded, randomized controlled study comparing the effectiveness of constraint-induced movement therapy or control treatment at post intervention and 12 weeks follow-up. SUBJECTS: The inclusion criteria were 2 to 16 weeks after stroke, hemiparesis of the affected limb, minimal function of >= 20 degrees wrist extension and >= 10 degrees extension of all digits and Mini-Mental State Examination score >= 17. INTERVENTIONS: The intervention group underwent a programme of 10 days upper extremity training (4 hours per day) with the unaffected limb being restrained in a shoulder sling and the control group received an equivalent duration of conventional rehabilitation therapy. MAIN MEASURES: Functional level for hemiparetic upper extremity, Motor Activity Log, Action Research Arm Test and modified Barthel Index. RESULTS: There were 23 and 20 subjects respectively in the constraint-induced movement therapy and control groups. Significant improvements were seen at post intervention and 12 weeks after constraint-induced movement therapy in functional level for hemiparetic upper extremity (p = 0.001), and in the 'amount of use' (p = 0.001) and 'how well' (p = 0.021) subscales of the Motor Activity Log. The total Action Research Arm Test score, grasp (p = 0.004), grip (p = 0.004), pinch (p = 0.032) and gross (p = 0.006) components showed significant improvement over the control group at post intervention. The grip component (p = 0.019) and the total Action Research Arm Test score (p = 0.009) were superior to the control group at 12 weeks. CONCLUSION: Significant improvement in hand function could be achieved with constraint-induced movement therapy in subacute stroke patients, which was maintained up to 12 week follow-up.

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