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|Constraint-induced movement therapy compared to dose-matched interventions for upper-limb dysfunction in adult survivors of stroke: a systematic review with meta-analysis [with consumer summary]|
|Stevenson T, Thalman L, Christie H, Poluha W|
|Physiotherapy Canada 2012 Fall;64(4):397-413|
PURPOSE: To summarize the existing literature examining constraint-induced movement therapy (CIMT), relative to dose-matched control interventions, for upper-limb (UL) dysfunction in adult survivors of stroke. METHODS: CINAHL, Cochrane Library, Ernbase, NARIC/CIRRIE-Rehabdata, PEDro, PubMed, Scopus, and Web of Science were searched from their inception to February 2011 trial quality was described using the PEDro scale. The findings were summarized with meta-analysis. RESULTS: For the 22 trials identified, the mean (SD) PEDro score was 6.4 (1.2). Meta-analysis showed CIMT to be superior to dose-matched interventions based on indicators of UL motor capacity (15 trials, n = 432; standardized mean difference (SMD) 0.47, 95% CI 0.27 to 0.66) and UL ability (14 trials, n = 352; SMD 0.80, 95% CI 0,57 to 1.02); Functional Independence Measure scores (6 trials, n = 182; mean difference (MD) 5.05, 95% CI 2.23 to 7.87); and Motor Activity Log scores (Amount of Use: 12 trials, n = 318; MD 1.05, 95% CI 0.85 to 1.24; Quality of Movement: 11 trials, n = 330; MD 0.89, 95% CI 0.69 to 1.08). CONCLUSIONS: Compared to control interventions of equal duration and dose, CIMT produced greater improvements in a variety of indicators of UL function in adult survivors of a stroke with residual movement of their upper limb.
A brief summary and a critical assessment of this review may be available at DARE