Article

Constraint-induced movement therapy (CIMT) is a rehabilitation
approach for arm paresis consisting of an intensive schedule of treatment (6
h/d). The high demand of resources for CIMT is a critical issue for its
implementation in the Italian health system. OBJECTIVE: To compare the effects of
a reduced-intensity modified CIMT (mCIMT) program that included splinting the
unaffected arm for 12 hours daily with the effects of a conventional
rehabilitation program for arm paresis in patients with stroke. METHODS: Sixty-six participants with hemiparesis (3-24 months poststroke) who could extend
the wrist and several fingers at least 10 degrees were randomly assigned to mCIMT
or conventional rehabilitation. Each group underwent 10 (2 h/d) treatment
sessions (5 d/wk for 2 weeks). Patients were assessed with the Wolf Motor
Function Test (WMFT-FA and WMFT-T), the Motor Activity Log (MAL-AOU and MAL-QOM),
and the Ashworth Scale before and after treatment and 3 months later. RESULTS:
Between-groups analysis showed that the mCIMT group overall had greater
improvement than the control group in terms of the WMFT-FA (P = .010), MAL-AOU (P
< .001), and MAL-QOM (P < .001). Differences between groups were significant both
after treatment (P < .01) and at the 3-month follow-up (P < .01), although 40% of
participants did not complete the 3-month assessment. Furthermore, the mCIMT
group showed a greater decrease of Ashworth Scale score than the control group at
3 months (P = .021). CONCLUSION: Two hours of CIMT may be more effective than
conventional rehabilitation in improving motor function and use of the paretic
arm in patients with chronic stroke.

Langue : ANGLAIS