Using kinematic analysis to evaluate constraint-induced movement therapy in chronic stroke patients

Objective. This preliminary study aims to verify if the method of kinematic analysis proposed here may be suitable for evaluating the effects of constraint-induced movement therapy (CIMT) in chronic stroke patients and may be of help in the study of the mechanisms underlying functional improvement following CIMT. Methods. Clinical and kinematic data were collected from a group of chronic stroke patients and from an age-matched healthy control group. Affected and less affected upper-limb kinematics related to hand-to-mouth and reaching movements were acquired before and immediately after 2 weeks of CIMT. Healthy subjects were submitted to kinematic analysis of the nondominant side and reevaluated after 2 weeks. Results. The clinical results were consistent with those reported in the literature and showed motor function improvement of the hemiparetic limb after CIMT. Kinematic data of the healthy control group showed high test-retest reliability. Statistically significant differences between the affected limb and both the less affected limb and the healthy subjects' nondominant limb were observed. After CIMT, kinematic data showed improvement in the speed of movement and in measures related to the capacity for coordination. Conclusions. The method of kinematic analysis was sensitive for an assessment of motor recovery induced by CIMT. The kinematic results suggest that the increase in the use of the paretic limb in activities of daily living after the intervention is not only attributable to the patient's increased attention to it and better hand dexterity, but it is also a consequence of the improved speed of movement and better coordination between shoulder and elbow joints.