Kate Hayner, Ginny Gibson, Gordon Muir Giles; Comparison of Constraint-Induced Movement Therapy and Bilateral Treatment of Equal Intensity in People With Chronic Upper-Extremity Dysfunction After Cerebrovascular Accident. Am J Occup Ther 2010;64(4):528-539. doi: 10.5014/ajot.2010.08027.
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© 2017 American Occupational Therapy Association
OBJECTIVE. We compared the effectiveness of constraint-induced movement therapy (CIMT) with bilateral treatment of equal intensity for chronic upper-extremity (UE) dysfunction caused by cerebrovascular accident (CVA).
DESIGN. We conducted a 2-group, randomized intervention trial with stratification by severity of UE dysfunction. Twelve community-dwelling adults were provided with 6 hr of occupational therapy for 10 days plus additional home practice. Six participants wore a mitt on the unimpaired UE, and 6 participants were intrusively and repetitively cued to use both UEs. The Wolf Motor Function Test (WMFT) and the Canadian Occupational Performance Measure (COPM) were administered before and after treatment and at 6-mo follow-up.
RESULTS. Significant improvements were found in WMFT and COPM scores across time in both groups. No significant between-group differences were found on the WMFT.
CONCLUSION. High-intensity occupational therapy using a CIMT or a bilateral approach can improve UE function in people with chronic UE dysfunction after CVA. Treatment intensity rather than restraint may be the critical therapeutic factor.
All participants will demonstrate improved total Wolf Motor Function Test (WMFT; Wolf et al., 2001) scores after CIMT or bilateral treatment of comparable intensity, frequency, duration, and activity selection.
Participants in the CIMT group will demonstrate greater improvement in total WMFT scores than participants in the bilateral group after treatment of comparable intensity, frequency, duration, and activity selection.
Participants with more impaired UE function, receiving either intervention, will demonstrate greater gains on the WMFT than the participants with less impaired UE function.
Participants with more impaired UE function (i.e., those who would typically not be included in a CIMT study) and who are receiving either intervention will demonstrate gains on the WMFT.
All participants will demonstrate improved scores on COPM subscales.
All participants will maintain gains established at posttesting on the total WMFT scores when tested at follow-up.
All participants will maintain gains established at posttesting on the COPM subscales when tested at follow-up.
Across both treatment groups, the participants with less impaired UE function will report more time spent in home activities.
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