Constraint-induced movement therapy for motor recovery in chronic stroke patients.

OBJECTIVE Assessment of the effectiveness of constraint-induced (CI) movement therapy and quantitative evaluation of the effects of CI therapy. DESIGN Intervention study; case series; pretreatment to posttreatment measures and follow-up 3 months after intervention. SETTING An outpatient department. PATIENTS Five chronic stroke patients with moderate motor deficit; convenience sample. INTERVENTIONS CI therapy consisting of restraint of the unaffected upper extremity in a sling for 14 days combined with 6 hours of training per weekday of the affected upper extremity. MAIN OUTCOME MEASURES Actual Amount of Use Test (AAUT), Motor Activity Log (MAL), Wolf Motor Function Test (WMFT), and Arm Motor Ability Test (AMAT) RESULTS: There was a substantial improvement in the performance times of the laboratory tests (AMAT, WMFT, p < or = .039) and in the quality of movement (AMAT, WMFT, p < or = .049; MAL, p = .049), particularly in the use of the extremity in "real world" environments (AAUT, p = .020), supported by results of quantitative evaluation. The effect sizes were large and comparable to those found in previous studies of CI therapy. CONCLUSIONS CI therapy is an efficacious treatment for chronic stroke patients, especially in terms of real world outcome.