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Effectiveness of constraint-induced movement therapy in chronic stroke patients.

Areerat Suputtitada8
Estimated H-index: 8
,
Nijasri C. Suwanwela18
Estimated H-index: 18
,
Tumvitee S1
Estimated H-index: 1
Sources
Abstract
Objective : The purpose of this study was to evaluate the effectiveness of constraint-induced movement therapy (CIMT) in dexterity with Action Research Arm Test (ARA test), hand grip strength, pinch strength of affected upper extremity in chronic stroke patients. Material and Method : An observer-blinded randomized control trial, 69 chronic stroke patients were allocated either to constraint-induced movement technique (n = 33) or conservative treatment (n = 36). The CIMT group received 6 hours of daily affected-upper-extremity training and restrained unaffected upper extremities for 5 days per week, totally 2 weeks. The control group received bimanual-upper-extremity training by conservative neurodevelopmental technique without restrained unaffected upper extremities for 2 weeks. Results : The CIMT group had ARA scores, pinch strength of affected upper extremities statistically significant higher than the control group at p 0.05. Conclusions : CIMT of unaffected upper extremities has an advantage for chronic stroke patients which may be an efficacious technique of improving motor activity and exhibiting learned nonuse.
  • References (34)
  • Citations (48)
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References34
Newest
#1Tommye K. MayerH-Index: 1
Temporary and long-term or permanent one-handedness affects a broad spectrum of the population and can result from injuries such as tendon strain, sprain, or fractures, or from neurological damage resulting from head injury or stroke. Rehabilitation has traditionally focused on re-establishing function in the disabled limb, or “restoring to former capacity.” This article examines rehabilitation as adaptation and explains three secrets to managing one-handed: (1) body positioning, (2) four finger...
2 Citations
#1Stefan Hesse (FU: Free University of Berlin)H-Index: 35
#2Henning SchmidtH-Index: 8
Last. Anita BardelebenH-Index: 13
view all 4 authors...
Purpose of reviewThe successful motor rehabilitation of stroke, traumatic brain-injured and spinal cord-injured patients requires an intensive and task-specific therapy approach. Budget constraints limit a hand-to-hand therapy approach, so that intelligent machines may offer a solution to promote mo
243 CitationsSource
#1Stefan Hesse (FU: Free University of Berlin)H-Index: 35
Last. C. Werner (FU: Free University of Berlin)H-Index: 11
view all 5 authors...
Abstract Hesse S, Schulte-Tigges G, Konrad M, Bardeleben A, Werner C. Robot-assisted arm trainer for the passive and active practice of bilateral forearm and wrist movements in hemiparetic subjects. Objective: To determine whether use of a robotic arm trainer for bilateral exercise in daily repetitive training for a 3-week period reduced spasticity and improved motor control in the arm of severely affected, chronic hemiparetic subjects. Design: Before-after trial. Setting: Community rehabilitati...
371 CitationsSource
#1Edward Taub (UAB: University of Alabama at Birmingham)H-Index: 77
#2Gitendra Uswatte (UAB: University of Alabama at Birmingham)H-Index: 40
Last. David M. Morris (UAB: University of Alabama at Birmingham)H-Index: 26
view all 3 authors...
massive cortical reorganization following Constraint-Induced Movement therapy Edward Taub, PhD*, Gitendra Uswatte, PhD, David M. Morris, MSPT Department of Psychology, University of Alabama at Birmingham, CPM 712, 1530 3 Avenue South, Birmingham, Alabama 35294-1170, USA Physical Medicine and Rehabilitation Service, Birmingham Veterans Affairs Medical Center, 700 19 Street South, Birmingham, Alabama 35233, USA Department of Physical Therapy, University of Alabama at Birmingham, 1705 University Bo...
96 CitationsSource
: PBWSTT has emerged from an interesting idea to a well-accepted and scientifically supported treatment modality for gait training after stroke. PBWSTT offers a task-specific approach to functional gait retraining that is based on rehearsal of repetitive controlled gait cycles. Newer devices are being developed that will provide better mechanical control of the patient and reduce therapist effort.
30 Citations
#1Hartwig Woldag (Leipzig University)H-Index: 11
#2Horst Hummelsheim (Leipzig University)H-Index: 13
In recent years, our understanding of motor learning, neuroplasticity and functional recovery after the occurrence of brain lesion has grown significantly. New findings in basic neuroscience provided stimuli for research in motor rehabilitation. Repeated motor practice and motor activity in a real world environment have been identified in several prospective studies as favorable for motor recovery in stroke patients. EMG initiated electrical muscle stimulation – but not electrical muscle stimula...
193 CitationsSource
#1David M. MorrisH-Index: 26
#2Edward Taub (UAB: University of Alabama at Birmingham)H-Index: 77
Traditional rehabilitation programs for persons with neurologic dysfunction emphasize a compensation, true recovery, or substitution approach to improve functional abilities. Constraint-induced (CI) movement therapy substantially increases more-affected extremity use in the life situation due to the influence of two different underlying mechanisms: overcoming learned nonuse and inducing use-dependent cortical reorganization. In this way, it bypasses the debate over whether a compensation, true r...
79 CitationsSource
#1Paul Bach-y-Rita (Universidad Autónoma del Estado de Morelos)H-Index: 1
AbstractRecovery of function after stroke appears to include elements of both restoration and compensation. The brain is highly plastic, which allows reorganization after damage. Stroke produces permanent damage to the brain, so recovery must be based on activity in surviving cells that are either adjacent, contralateral, or in a different region. Furthermore, representation of a particular function in the brain is usually not limited to a single brain region. Multiple representation provides th...
50 CitationsSource
ABSTRACTLevy CE, Nichols DS, Schmalbrock PM, Keller P, Chakeres DW: Functional MRI evidence of cortical reorganization in upper-limb stroke hemiparesis treated with constraint-induced movement therapy. Am J Phys Med Rehabil 2001;80:4–12.ObjectiveThe purpose of this pilot study was to test constraint
253 CitationsSource
#1J. H. Van der Lee (VU: VU University Amsterdam)H-Index: 3
#2Robert C. Wagenaar (VU: VU University Amsterdam)H-Index: 40
Last. Lex M. BouterH-Index: 140
view all 6 authors...
Background and Purpose—Of all stroke survivors, 30% to 66% are unable to use their affected arm in performing activities of daily living. Although forced use therapy appears to improve arm function in chronic stroke patients, there is no conclusive evidence. This study evaluates the effectiveness of forced use therapy. Methods—In an observer-blinded randomized clinical trial, 66 chronic stroke patients were allocated to either forced use therapy (immobilization of the unaffected arm combined wit...
614 CitationsSource
Cited By48
Newest
#1Heejoong Kim (Graduate School USA)
#2Yijung Chung (Sahmyook University)H-Index: 10
Purpose: This study aimed to investigate the effect of progressive speed increase during underwater gait training on stroke patients’ balance, gait, and endurance, as well as to compare the effects of underwater gait training and land gait training. Methods: Subjects were randomly allocated into three groups. Underwater gait training group (n=10), land gait training group (n=9) and control group (n=9). The groups performed their respective programs as well as conventional physical therapy 3 tim...
Source
#1Pei-ming Chen (PolyU: Hong Kong Polytechnic University)H-Index: 1
#2Patrick W. H. Kwong (PolyU: Hong Kong Polytechnic University)H-Index: 4
Last. Shamay S. M. Ng (PolyU: Hong Kong Polytechnic University)H-Index: 15
view all 4 authors...
Background and objectives Bilateral upper limb training (BULT) and unilateral upper limb training (UULT) are two effective strategies for the recovery of upper limb motor function after stroke. This meta-analysis aimed to compare the improvements in motor impairment and functional performances of people with stroke after BULT and UULT. Research design and methods This systematic review and meta-analysis identified 21 randomized controlled trials (RCTs) met the eligibility criteria from CINAHL, M...
1 CitationsSource
Abstract Study Design Pretest/posttest case series design. Introduction Rates of prosthetic device abandonment are highest among persons with upper extremity (UE) amputation. Modified Constraint-Induced Movement Therapy (mCIMT), which has been extensively studied in patients with chronic, subacute, and acute stroke, is an under-utilized approach to treat persons with UE amputation. Purpose of the Study To present an mCIMT intervention for prosthetic device training after a unilateral UE amputati...
Source
Source
#1Yejin Lee (Yonsei University)H-Index: 1
#2Moon Young KimH-Index: 25
Last. Hae Yean Park (Yonsei University)H-Index: 2
view all 4 authors...
BACKGROUND: The differential effects of bilateral and unilateral training on upper extremity (UE) function remain unclear. OBJECTIVE: To compare the effectiveness of bilateral and unilateral training on UE function and activities of daily living (ADL) after stroke. METHODS: Randomized controlled trials (RCTs) were selected for inclusion by two reviewers after searching the following databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and KoreaMed. Methodological...
3 CitationsSource
#1Davide Corbetta (UniSR: Vita-Salute San Raffaele University)H-Index: 7
#2Valeria Sirtori (UniSR: Vita-Salute San Raffaele University)H-Index: 5
Last. Roberto GattiH-Index: 20
view all 5 authors...
Background In people who have had a stroke, upper limb paresis affects many activities of daily life. Reducing disability is therefore a major aim of rehabilitative interventions. Despite preserving or recovering movement ability after stroke, sometimes people do not fully realise this ability in their everyday activities. Constraint-induced movement therapy (CIMT) is an approach to stroke rehabilitation that involves the forced use and massed practice of the affected arm by restraining the unaf...
28 CitationsSource
#1Júlia Caetano Martins (UFMG: Universidade Federal de Minas Gerais)H-Index: 7
#2Luci Fuscaldi Teixeira-Salmela (UFMG: Universidade Federal de Minas Gerais)H-Index: 30
Last. Christina Danielli Coelho de Morais Faria (UFMG: Universidade Federal de Minas Gerais)H-Index: 15
view all 6 authors...
Introduction Clinical measurements of strength in stroke subjects are usually performed and portable dynamometers are one of the most employed instruments. Objective To verify the standardization procedures of the methods used to assess the strength of the trunk and upper limb muscles with portable dynamometers in stroke subjects, as well as to assess the psychometric properties which were already investigated. Materials and methods An extensive search was performed on the MEDLINE, SciELO, LILAC...
7 CitationsSource
#1G. Kwakkel (VUmc: VU University Medical Center)H-Index: 68
#2Janne M. Veerbeek (VUmc: VU University Medical Center)H-Index: 11
Last. Steven L. Wolf (American Physical Therapy Association)H-Index: 69
view all 4 authors...
Summary Constraint-induced movement therapy (CIMT) was developed to overcome upper limb impairments after stroke and is the most investigated intervention for the rehabilitation of patients. Original CIMT includes constraining of the non-paretic arm and task-oriented training. Modified versions also apply constraining of the non-paretic arm, but not as intensive as original CIMT. Behavioural strategies are mostly absent for both modified and original CIMT. With forced use therapy, only constrain...
123 CitationsSource
#1Defne KayaH-Index: 1
2 Citations
#1Gyrd ThraneH-Index: 6
#2Oddgeir FriborgH-Index: 24
Last. Bent IndredavikH-Index: 29
view all 4 authors...
OBJECTIVE: To evaluate the effect of constraint-induced movement therapy in adult stroke patients and to examine the impact of time since stroke and various treatment modalities. DATA SOURCES: PubMed, EMBASE, Cochrane and PEDro trial registers were searched for clinical trials published before November 2012. STUDY SELECTION: Randomized or quasi-randomized controlled trials of constraint-induced movement therapy lasting 2-7 h/day for 8-28 days were included. DATA EXTRACTION: Measurements were cla...
26 CitationsSource