Stephen J. Page, Colleen Murray, Valerie Hermann; Affected Upper-Extremity Movement Ability Is Retained 3 Months After Modified Constraint-Induced Therapy. Am J Occup Ther 2011;65(5):589-593. doi: 10.5014/ajot.2011.000513.
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The practicality and patient compliance of constraint-induced movement therapy limit its application in many clinical environments. For more than a decade, the principal investigator's laboratory has shown efficacy of an outpatient, modified constraint-induced therapy (mCIT). The current study examined whether participants administered mCIT retained motor changes 3 mo after intervention. The upper-extremity section of the Fugl-Meyer Impairment Scale (FM) and the Action Research Arm Test (ARA) were administered directly after mCIT intervention. Thirteen patients poststroke were tracked prospectively from directly after intervention concluded to 3 mo after intervention, at which time the FM and ARA were readministered. Three months after intervention, 25 of the 26 scores on the FM and ARA increased between the time after intervention and 3 months after intervention, reflecting continued increases in affected extremity movement ability. It is believed that the continued motor changes were caused by the comparatively larger number of extremity-use opportunities during the 10-wk mCIT intervention period. These opportunities encourage habitual extremity use even after the intervention period has concluded, leading to the changes observed.
Able to actively extend the affected wrist a minimum of 10° and actively extend the metacarpophalangeal (MP) joints of the thumb and at least 2 additional MP joints in two additional fingers at least 10°, repeating the movements at least 3 times in 1 min
Stroke experienced >3 mo before study enrollment
A score ≥ 70 on the Modified Mini-Mental State Examination (Teng & Chui, 1987)
No hemorrhagic lesions
Age >18 and <85 yr
No excessive spasticity in the affected biceps, triceps, wrist, or fingers, as defined by a score ≤2 on the Modified Ashworth Spasticity Scale (Bohannon & Smith, 1987)
No excessive pain in the affected upper extremity, as measured by a score ≤5 on a 10-point visual analog scale
Discharged from all forms of physical rehabilitation.
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