Stroke patients affected by an upper-extremity movement dysfunction reported comparatively high levels of effectiveness from constraint-induced movement therapy (CIMT) in improving their daily activities. But in measures of motor function, CIMT fared no better than standard therapy, according to a study published recently in The Lancet Neurology.
The study, led by Anne Barzel, MD, was conducted in Germany and used study subjects from 71 therapy practices in northern Germany. One group of therapy practices was assigned at random to provide 4 weeks of home-based CIMT to study subjects, while another group provided 4 weeks of standard therapy.
Study subjects were qualified for the research based on having mild to moderate impairment of arm function at least 6 months after stroke. Study subjects in both groups received 5 hours of professional therapist contact in 4 weeks, according to a summary published in The Lancet Neurology.
Patients in the standard therapy group received conventional physical or occupational therapy, but additional home training was not obligatory. In the home CIMT group, therapists used the time allotted with the study subjects to instruct and supervise the study subjects as well as their coaches, who were a family member or friend.
According to the summary in The Lancet Neurology, there were two primary outcomes—the first of which was quality of movement, assessed by the Motor Activity Log (MAL-QOM, assessor-assisted self-reported). The second outcome was performance time, assessed by the Wolf Motor Function Test (WMFT-PT, assessor-reported).
Study subjects were assessed at 4 weeks. The researchers reported that study subjects in the home-based CIMT group demonstrated greater improvement than patients in the standard therapy group. The researchers note that while both groups also improved in motor function performance time, the extent of that improvement between the two groups was not significant.
“Home-based CIMT can enhance the perceived use of the stroke-affected arm in daily activities more effectively than conventional therapy but was not superior with respect to motor function,” the authors conclude.
[Source: The Lancet Neurology]