The effectiveness of a modified constraint induced movement therapy program in patients with acute or subacute stroke: a real-life study

Abstract

The aim of this study was to investigate whether a two-week Modified CIMT-program provided in a clinical setting, improves the upper limb capacity in stroke patients.

The patients were selected in the rehabilitation centre of Sint-Ursula, Herk-de-Stad. Inclusion criteria were (1) at least one month post stroke, (2) > age of 18 years, (3) the patient should meet the Taub criteria which means they should be able to: actively extend the wrist on the affected side for a minimum of 10 degrees, actively extend two digits on the affected side for a minimum of 10 degrees, and actively abduct the thumb on the affected side for a minimum of 10 degrees , (4) being able to walk independently or with a walking aid , (7) understanding simple motor commands.

To measure the upper limb capacity, the Action Research Arm Test (ARAT) and the upper limb section of the Brunnstrom Fugl-Meyer (UL-BFM) were used.

In total, 43 patients were analysed. There was a significant increase in the UL-BFM and ARAT over time (p < 0.0001). The mean difference for the ARAT and UL-BFM was 9.07 (SD = 9.36) and 6.42 (SD = 7.43), respectively. The mean results for the ARAT and UL-BFM were below the minimal clinical important difference (ARAT = 12 and UL-BFM = 9.5). However 15 patients had an improvement which was above the MCID of the ARAT and the UL-BFM.