Constraint-induced movement therapy for motor recovery in chronic stroke patients

Objective: Assessment of the effectiveness of constraint-induced (CI) movement therapy and quantitative evaluation of the effects of CI therapy. Design: Intervention study; case series; pretreatment to posttreatment measures and follow-up 3 months after intervention. Setting: An outpatient department. Patients: Five chronic stroke patients with moderate motor deficit; convenience sample. Interventions: CT therapy consisting of restraint of the unaffected upper extremity in a sling for 14 days combined with 6 hours of training per weekday of the affected upper extremity. Main Outcome Measures: Actual Amount of Use Test (AAUT), Motor Activity Log (MAL), Wolf Motor Function Test (WMFT), and Arm Motor Ability Test (AMAT). Results: There was a substantial improvement in the performance times of the laboratory tests (AMAT, WMFT, p less than or equal to.039) and in the quality of movement (AMAT, WMFT, p less than or equal to.049; MAL, p =.049), particularly in the use of the extremity in "real world" environments (AAUT, p =.020), supported by results of quantitative evaluation. The effect sizes were large and comparable to those found in previous studies of CI therapy. Conclusions: CI therapy is an efficacious treatment for chronic stroke patients, especially in terms of real world outcome. (C) 1999 by the American Congress of Rehabilitation Medicine and the American Academic of Physical Medicine and Rehabilitation.