Constraint-Induced Movement Therapy in Compared to Traditional Therapy in Chronic Post-stroke patients

Introduction: Constraint-induced movement therapy (CIMT) forces the use of the affected side by restraining the unaffected side. The purpose of this article is to explore the changes of motor and functional performance after modified CIMT (mCIMT) in comparison with traditional rehabilitation (TR) in chronic post-stroke patients. Material and Methods: A total of 12 patients randomly assigned into two treatment groups. Six patients in the mCIMT group received intensive training in a more affected limb for 2 hours daily, 5 days/week using shaping method over a period of 21 days. Participants less affected limb were restrained in arm - hand splint with a target of wearing it for 5 hours daily. The patients in TR group received bimanual and unilateral activities, stretching, strengthening and coordination exercises of the impaired side, tone modification and coordination exercises of the affected side. The focus was to increase independence in activities of daily living activities  using  affected  side.  The  motor  activity  log (MAL),  wolf  motor  function  test (WMFT), and modified ashworth scale were measured at pre-test (1 day before training), post- test (1 day after training) and follow-up in 3 weeks after training. Results: The  Friedman  test  found  significant differences  between  pre-test,  post-test,  and follow-up in MAL and WMFT in mCIMT group. Furthermore, mCIMT group showed significant decreased spasticity (P = 0.030) that measured by ash worth scale. The effect sizes between post-test and pre-test in the above-mentioned outcome measures were moderate to large in mCIMT, ranging from 0.3 to 0.76, but in TR group the effect size were small, ranging from 0 to 0.2. Conclusion: Therefore, it seems that the mCIMT treatment was more effective than TR in improving some parameters.