Effects of constraint-induced movement therapy on patients with chronic motor deficits after stroke - A replication

Background and Purpose-Constraint-induced movement therapy (CI therapy) has previously been shown to produce large improvements in actual amount of us e of a more affected upper extremity in the "real-world" environment in pat ients with chronic stroke (ie, >1 year after the event). This work was carr ied out in an American laboratory. Our aim was to determine whether these r esults could be replicated in another laboratory located in Germany, operat ing within the context of a healthcare system in which administration of co nventional types of physical therapy is generally more extensive than in th e United States, Methods Fifteen chronic stroke patients were given CI therapy, involving re striction of movement of the intact upper extremity by placing it in a slin g for 90% of waking hours for 12 days and training (by shaping) of the more affected extremity for 7 hours on the 8 weekdays during that period. Results Patients showed a significant and very large degree of improvement from before to after treatment on a laboratory motor test and on a test ass essing amount of use of the affected extremity in activities of daily livin g in the Life setting (effect sizes, 0.9 and 2.2, respectively), with no de crement in performance at 6-month follow-up. During a pretreatment control test-retest interval, there were no significant changes on these tests. Conclusions-Results replicate in Germany the findings with CI therapy in an American laboratory, suggesting that the intervention has general applicab ility.