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Phase II Randomized Controlled Trial of Constraint-Induced Movement Therapy in Multiple Sclerosis. Part 1: Effects on Real-World Function

Published on Mar 1, 2018in Neurorehabilitation and Neural Repair3.757
· DOI :10.1177/1545968318761050
Victor W. Mark23
Estimated H-index: 23
(UAB: University of Alabama at Birmingham),
Edward Taub77
Estimated H-index: 77
(UAB: University of Alabama at Birmingham)
+ 5 AuthorsStaci McKay5
Estimated H-index: 5
(UAB: University of Alabama at Birmingham)
Abstract
Background. Constraint-Induced Movement therapy (CIMT) has controlled evidence of efficacy for improving real-world paretic limb use in non-progressive physically disabling disorders (stroke, cerebral palsy). Objective. This study sought to determine whether this therapy can produce comparable results with a progressive disorder such as multiple sclerosis (MS). We conducted a preliminary phase II randomized controlled trial of CIMT versus a program of complementary and alternative medicine (CAM) treatments for persons with MS, to evaluate their effect on real-world disability. Methods. Twenty adults with hemiparetic MS underwent 35 hours of either CIMT or CAM over 10 consecutive weekdays. The primary clinical outcome was change from pretreatment on the Motor Activity Log (MAL). Results. The CIMT group improved more on the MAL (2.7 points, 95% confidence interval 2.2-3.2) than did the CAM group (0.5 points, 95% confidence interval −0.1 to 1.1; P < .001). These results did not change at 1-year follow-up, in...
  • References (44)
  • Citations (3)
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References44
Newest
#1Michael K. Marquardt (University of Konstanz)H-Index: 4
#2Anna-Lisa Cohen (Yeshiva University)H-Index: 13
Last. Christian DettmersH-Index: 30
view all 5 authors...
Background: After stroke, the learned non-use of a paretic arm is a major obstacle to the improvement of hand function. / Objective: We examined whether patients with a central paresis could profit from applying the self-regulation strategy of making if-then plans that specify situational triggers to using the paretic arm. / Method: Seventeen stroke patients with a mild to moderate hand paresis were asked to perform a Simon task which is commonly used to study the enhanced executive control need...
2 CitationsSource
#1Robert W. Motl (UIUC: University of Illinois at Urbana–Champaign)H-Index: 67
#2Lara A. Pilutti (UIUC: University of Illinois at Urbana–Champaign)H-Index: 25
ABSTRACTIntroduction: There is consensus that exercise represents a behavioral approach for the restoration of function and management of symptoms among persons with multiple sclerosis (MS). The current paper provides a review on the topic of exercise and physical activity as MS-disease modifying treatments.Areas covered: Firstly, metrics for evaluating disease modification and progression in MS are described. Secondly, evidence for exercise as a MS-disease modifying therapy based on individual ...
20 CitationsSource
#1Ilse Lamers (University of Hasselt)H-Index: 15
#2Anneleen Maris (University of Hasselt)H-Index: 3
Last. Peter Feys (University of Hasselt)H-Index: 30
view all 7 authors...
Background. There has been an increasing research interest in upper limb rehabilitation in multiple sclerosis (MS). The current changes in the research field inquire a new literature review. Objective. This systematic review aimed to provide an overview of the upper limb rehabilitation strategies in people with MS (PwMS). Methods. Articles published in PubMed and Web of Knowledge were selected when written in English, published in the past 25 years, peer reviewed, that included at least 5 PwMS, ...
29 CitationsSource
#1Jodie K. HaselkornH-Index: 26
#2Christina HughesH-Index: 4
Last. Pushpa NarayanaswamiH-Index: 15
view all 12 authors...
Objective: To systematically review the evidence regarding rehabilitation treatments in multiple sclerosis (MS). Methods: We systematically searched the literature (1970–2013) and classified articles using 2004 American Academy of Neurology criteria. Results: This systematic review highlights the paucity of well-designed studies, which are needed to evaluate the available MS rehabilitative therapies. Weekly home/outpatient physical therapy (8 weeks) probably is effective for improving balance, d...
31 CitationsSource
#1Sooyoung Kim (University of California, Berkeley)H-Index: 12
#2Rachel P. AllredH-Index: 13
Last. Theresa A. Jones (University of Texas at Austin)H-Index: 43
view all 7 authors...
Following unilateral stroke, the contralateral (paretic) body side is often severely impaired, and individuals naturally learn to rely more on the nonparetic body side, which involves learning new skills with it. Such compensatory hyper-reliance on the “good” body side, however, can limit functional improvements of the paretic side. In rats, motor skill training with the nonparetic forelimb (NPT) following a unilateral infarct lessens the efficacy of rehabilitative training, and reduces neuronal...
17 CitationsSource
#1Rita BertoniH-Index: 5
#2Ilse Lamers (University of Hasselt)H-Index: 15
Last. Davide CattaneoH-Index: 19
view all 5 authors...
Background:There has been limited research on upper limb dysfunction in people with multiple sclerosis (PwMS).Objective:The objective of this paper is to study unilateral and bilateral upper limb dysfunction at different International Classification of Functioning (ICF) levels according to overall disability in PwMS.Methods:A total of 105 PwMS (16 with EDSS 6.5 (severe non-ambulant)) were recruited from two rehabilitation centers and assessed in a cross-sectional study.Results:The whole sample s...
32 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
#1Takashi Takebayashi (Hyogo College of Medicine)H-Index: 6
#2Satoru Amano (Hyogo College of Medicine)H-Index: 4
Last. Kazuhisa DomenH-Index: 18
view all 9 authors...
AbstractBackground:Despite the confirmed short-term effects of constraint-induced movement therapy, the long-term effects have not been sufficiently verified in terms of functional improvement of the affected arm.Objective:To evaluate the long-term effects and relationship between arm use in activities of daily living and arm improvement with modified constraint-induced movement therapy in chronic stroke patients.Methods:At 1 year after completing modified constraint-induced movement therapy, ar...
9 CitationsSource
#1Jodie K. HaselkornH-Index: 26
#2Christina HughesH-Index: 4
Last. Pushpa NarayanaswamiH-Index: 15
view all 12 authors...
4 CitationsSource
#1Murray G. Brown (Capital District Health Authority)H-Index: 1
#2Mark Asbridge (Dal: Dalhousie University)H-Index: 28
Last. Dong Lin (Dal: Dalhousie University)H-Index: 1
view all 7 authors...
Introduction Multiple sclerosis (MS) is a chronic disease of the central nervous system. Estimates of MS natural history (NH) disability progression speed from clinical observations vary worldwide. This may reflect, in part, variance in censoring-bias) (missing observations) and assumptions about when irreversible disability progression events occurred. We test whether estimates of progression speed which assume midpoint survival time at irreversible disability endpoints are significantly faster...
5 CitationsSource
Cited By3
Newest
#1Paul D. Loprinzi (University of Mississippi)H-Index: 31
#2Jacob Harper (University of Mississippi)
Last. Toshikazu Ikuta (University of Mississippi)H-Index: 17
view all 3 authors...
Objective: To evaluate the influence of exercise on the body and genu of the corpus callosum (CC), which is a critical brain structure involved in facilitating interhemispheric communication. Methods: Studies were identified using electronic databases, including PubMed, PsychInfo, Sports Discus and Google Scholar. The search terms, including their combinations, included exercise, physical activity, cardiorespiratory fitness, interhemispheric, and corpus callosum. To be eligible for inclusion in ...
Source
#1Sarah Monteiro dos Anjos (UAB: University of Alabama at Birmingham)H-Index: 1
#2David M. Morris (UAB: University of Alabama at Birmingham)H-Index: 26
Last. Edward Taub (UAB: University of Alabama at Birmingham)H-Index: 77
view all 3 authors...
Constraint-Induced Movement Therapy (CIMT) is comprised of a set of techniques shown to produce significant changes in upper extremity (UE) function following stroke and other disorders. The significant positive results obtained with the UE protocol has led to the development of LE-CIMT, an intervention to improve lower extremity (LE) function. However, some modifications of the UE protocol were needed including: omitting use of a restraint device, development of supervised motor training tasks ...
Source
#1Nicola ValèH-Index: 2
#2Marialuisa GandolfiH-Index: 17
Last. Mirko FilippettiH-Index: 2
view all 17 authors...
Background: Multiple sclerosis (MS) is a chronic inflammatory demyelinating and disabling disease which primarily affects individuals in their early life between 20 and 40 years of age. MS is a complex condition, which may lead to a variety of upper limb (UL) dysfunctions and functional deficits. Objective: To explore upper limb impairments at body function, activity, and participation in persons with MS (PwMS) and severe hand dexterity impairment by behavioral and surface electromyography (sEMG...
1 CitationsSource
#1Alessandro de Sire (University of Eastern Piedmont)H-Index: 1
#2Matteo BigoniH-Index: 6
Last. Alessandro Mauro (UNITO: University of Turin)H-Index: 34
view all 6 authors...
Source
#1Ann Van de Winckel (UMN: University of Minnesota)H-Index: 12
#1A Vanwinckel (UMN: University of Minnesota)H-Index: 15
Last. Lynne V. Gauthier (University of Massachusetts Lowell)
view all 2 authors...
Objectives. To derive a shorter version of the Motor Activity Log Quality-of-Movement Scale (MAL-28) with enhanced content and construct validity. Design. Validation cohort. Setting. Outpatient reh...
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