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

Objective: Assessment of the effectiveness of constraint-induced (CI) movem ent therapy and quantitative evaluation of the effects of CI therapy. Design: Intervention study; case series; pretreatment to posttreatment meas ures and follow-up 3 months after intervention. Setting: An outpatient department. Patients: Five chronic stroke patients with moderate motor deficit; conveni ence sample. Interventions: CT therapy consisting of restraint of the unaffected upper e xtremity in a sling for 14 days combined with 6 hours of training per weekd ay 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 th e laboratory tests (AMAT, WMFT, p less than or equal to.039) and in the qua lity of movement (AMAT, WMFT, p less than or equal to.049; MAL, p =.049), p articularly in the use of the extremity in "real world" environments (AAUT, p =.020), supported by results of quantitative evaluation. The effect size s were large and comparable to those found in previous studies of CI therap y. Conclusions: CI therapy is an efficacious treatment for chronic stroke pati ents, especially in terms of real world outcome. (C) 1999 by the American C ongress of Rehabilitation Medicine and the American Academic of Physical Me dicine and Rehabilitation.