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Modified Constraint-Induced Therapy in Chronic Stroke: Results of a Single-Blinded Randomized Controlled Trial

SJ Page, PhD, FAHA, is Director of Research and Associate Professor, Departments of Rehabilitation Sciences, Physical Medicine and Rehabilitation, and Neurosciences; a member of the Greater Cincinnati/Northern Kentucky Stroke Team; and a Scholar at The Institute for the Study of Health, all at the University of Cincinnati Academic Medical Center, Cincinnati, Ohio. Dr Page also is Director of the Neuromotor Recovery and Rehabilitation Laboratory at Drake Center, Cincinnati, Ohio. Mailing address: 3202 Eden Ave, Suite 310, Cincinnati, OH 45267-0394 (USA)
P Levine, PTA, BA, is Senior Research Assistant, Department of Rehabilitation Sciences, University of Cincinnati Academic Medical Center, and Co-Director of the Neuromotor Recovery and Rehabilitation Laboratory at Drake Center
A Leonard, PhD, is Biostatistician, Institute for the Study of Health, University of Cincinnati College of Medicine
JP Szaflarski, MD, PhD, is Assistant Professor of Neurology, University of Cincinnati College of Medicine
BM Kissela, MD, is a member of the Greater Cincinnati/Northern Kentucky Stroke Team and an Assistant Professor of Neurology, University of Cincinnati College of Medicine

Background and Purpose: This single-blinded randomized controlled trial compared the efficacy of a reimbursable, outpatient, modified constraint-induced therapy (mCIT) protocol (half-hour therapy sessions occurring 3 days per week in which subjects used the more affected arm combined with less affected arm restriction 5 days per week for 5 hours; both of these regimens were administered during a 10-week period) with that of a time-matched exercise program for the more affected arm or a no-treatment control regimen.

Subjects: Thirty-five subjects with chronic stroke participated in the study.

Methods: The Action Research Arm Test (ARAT), Fugl-Meyer Assessment of Motor Recovery After Stroke (FM), and Motor Activity Log (MAL) were administered to the subjects.

Results: After intervention, significant differences were observed on the ARAT and MAL Amount of Use and Quality of Movement scales, all in favor of the mCIT group.

Discussion and Conclusion: The data affirm previous findings suggesting that this reimbursable, outpatient protocol increases more affected arm use and function. Magnitude of changes was consistent with those reported in more intense protocols, such as constraint-induced therapy.

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