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Pain, Fatigue, and Intensity of Practice in People With Stroke Who Are Receiving Constraint-Induced Movement Therapy

J Underwood, BSN, RN, is Clinical Research Associate, Pharmaceutical Product Development Inc, Morrisville, NC. She was a research honors nursing student at Emory University, Atlanta, Ga, when most of this work was completed
PC Clark, PhD, RN, FAHA, FAAN, is Associate Professor, Byrdine F. Lewis School of Nursing, Georgia State University, Atlanta, Ga. She was a faculty member at Emory University when most of this work was completed
S Blanton, PT, DPT, NCS, is Physical Therapist and Associate Director of Research Projects, Center for Rehabilitation Medicine, Emory University School of Medicine, Atlanta, Ga
DM Aycock, MSN, APRN-BC, is Clinical Instructor, Byrdine F. Lewis School of Nursing, Georgia State University. She was a senior research nurse at Emory University when most of this work was completed
SL Wolf, PT, PhD, FAPTA, is Professor, Center for Rehabilitation Medicine, Emory University School of Medicine, 1441 Clifton Rd NE, Atlanta, GA 30332 (USA)

Address all correspondence to Dr Wolf at: swolf{at}emory.edu

Background and Purpose. There is little available information about changes in pain and fatigue status among people receiving constraint-induced movement therapy (CI therapy). This study examined such changes. Subjects. All participants were a subset of individuals with stroke enrolled in the Extremity Constraint-Induced Therapy Evaluation (EXCITE) trial and received 2 weeks of CI therapy either 3 to 9 months after stroke (subacute therapy group, n=18) or 1 year later (chronic therapy group, n=14). Methods. Pain, fatigue, and intensity of therapy were evaluated. The Wolf Motor Function Test (WMFT) and the pain scale of the Fugl-Meyer Assessment for the upper extremity were administered before and after training. Single-item measures for pain and fatigue were administered twice daily during therapy. Results. All participants reported low mean pain (=2.0, SD=0.93) and fatigue (=2.7, SD=1.23) scores. Generally, differences between the subacute and the chronic therapy groups for pain, fatigue, intensity, and WMFT change scores were nonsignificant. Discussion and Conclusion. For selected patients with stroke, the intensive practice associated with CI therapy may be administered without exacerbation of pain or fatigue, even early during the recovery process.

Key Words: Cerebrovascular accident • Fatigue • Pain • Rehabilitation

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