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Sirtori V et al. – Constraint–induced movement therapy (CIMT) is a type of rehabilitation therapy in which the patient is obliged to use the paralysed arm. The normal arm and hand are prevented from moving with a glove and a special arm rest. The authors found 19 studies involving 619 participants, which assessed whether CIMT could reduce disability in stroke patients with a paralysed arm. CIMT is a multifaceted intervention: the restriction to the normal limb is accompanied by a certain amount of exercise of the appropriate quality. It is associated with a moderate reduction in disability assessed at the end of the treatment period. However, for disability measured some months after the end of treatment, there was no evidence of persisting benefit. Further randomised trials, with larger sample sizes and longer follow up, are justified.


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