Is modified constraint-induced movement therapy more effective than bimanual training in improving arm motor function in the subacute phase post stroke- A randomized controlled trial
Clinical Rehabilitation, 06/08/2012
Brunner IC et al. – Bimanual training was as effective as modified constraint–induced movement therapy in improving arm motor function. Wearing a mitt seems unnecessary for most patients in the subacute phase post stroke when focused affected arm training is provided.Methods
- Thirty patients in the subacute phase post stroke (2-16 weeks) were randomized to modified constraint-induced movement therapy with an emphasis on unimanual tasks, or bimanual task-related training, emphasizing bimanual tasks.
- All trained with a therapist 4 hours a week for four weeks, followed by a 2-3 hours daily self-training program.
- Patients in the modified constraint-induced movement therapy group were supposed to wear a restraining mitt on the unaffected hand for 4 hours a day for four weeks.
- Blinded assessments at pre and post treatment and after three months with Action Research Arm Test as a primary outcome measure, Nine-Hole Peg Test and Motor Activity Log.
- Power calculations suggested an inclusion of 60 patients, but due to recruitment difficulties the trial was stopped after an interim analysis at 30 patients.
- There was no difference in change (P>0.05) between the groups on any of the measures, neither at post treatment nor at follow-up assessments.
- From pre- intervention to follow-up assessment the modified constraint-induced movement therapy group obtained a mean change score of 17.77 (14.66) on Action Research Arm Test, the bimanual group 15.47 (13.59).