Article

Constraint-induced movement therapy (CIMT) is a neurorehabilitation technique
designed to improve upper extremity motor functions after stroke. This review
aimed to investigate evidence of the effect of CIMT on upper extremity in stroke
patients and to identify optimal methods to apply CIMT. Four databases (MEDLINE,
EMBASE, CINHAL, and PEDro) and reference lists of relevant articles and reviews
were searched. Randomized clinical trials that studied the effect of CIMT on
upper extremity outcomes in stroke patients compared with other rehabilitative
techniques, usual care, or no intervention were included. Methodological quality
was assessed using the PEDro score. The following data were extracted for each
trial: patients' characteristics, sample size, eligibility criteria, protocols of
CIMT and control groups, outcome measurements, and the PEDro score. A total of 38
trials were identified according to the inclusion criteria.
The trials included
were heterogeneous in CIMT protocols, time since stroke, and duration and
frequency of treatment. The pooled meta-analysis of 36 trials found a
heterogeneous significant effect of CIMT on upper extremity. There was no
significant effect of CIMT at different durations of follow-up. The majority of
included articles did not fulfill powered sample size and quality criteria. The
effect of CIMT changed in terms of sample size and quality features of the
articles included. These meta-analysis findings indicate that evidence for the
superiority of CIMT in comparison with other rehabilitative interventions is
weak. Information on the optimal dose of CIMT and optimal time to start CIMT is still limited.

Langue : ANGLAIS