Effectiveness Of Constraint-induced Movement Therapy On Upper Extremities With Sub-acute Stroke

Objective:The purpose of this evidence-based analysis is exploring the effectiveness ofConstraint-induced Movement Therapy (CIMT).Compared with conventionaloccupational therapy, if both of them have effectiveness on person who is suffer fromupper limb and hand dysfunctional in sub-acute stroke.Analysis the mechanism andwhy CIMT has effectiveness on person who had arm dysfunction after sub-acutestroke.Method:42in clinical stroke patients were recruited from the First Hospital of JilinUniversity during March2012to March2013; all the participants with onset betweenthe ages of18-80years old.Onset time from3weeks to6months. All of the patientsaccordant with inclusion criteria were randomly divided into2groups:Constraint-induced movement therapy (CIMT group) and Occupational Therapy (OTgroup) and21patients in each group.6patients fail to finish the final test. Both of theteams have18patients.It takes them a total of three weeks, five days a week,3hoursa day to finish all the therapy. Far from OT team, CIMT team restrict the contralateralupper limb and reinforce training ipsilateral upper extremity with shaping.Remindingpatients use ipsilateral upper extremity in the every environment.Upper-extremitymotor ability was assessed with Wolf Motor Function Test(WMFT),Fugl-MeyerAssessment and Barthel Index at pre、post one day and30days after therapy.According to the principle of voluntaries, we recruit another18patients in OT groupto join the new CIMT after treatment and assessment. Among whom there are15person accept CIMT. We signed this group CIMT-2group. All of them receive atotal of three weeks, five days a week,3hours a day to finish all the therapy..Thetreatment、 restriction and assessment are the same as CIMT group.Theirupper-extremity motor ability also assess with Wolf Motor Function Test(WMFT),Fugl-Meyer Assessment and Barthel Index at pre、post one day and30days after therapy.Results:The motor ability of both upper-extremities were improved than before, thedifference was significant (P<0.05).The effectiveness of CIMT is more obvious thanOT(p<0.05).After3weeks of constraint use of ipsilateral upper extremity, thefunction of CIMT-2group patients were deeply improvement, the difference wassignificant (P<0.05).Conclusion:Rehabilitation could improve the upper limb and hand functional in sub-acutestroke.Significant improvement in the use of affected upper extremity and hand couldbe achieved with constraint-induced movement therapy in sub-acute strokepatients.Their movement function and activity of daily living both improved after3-weeks therapy.It is proved that CIMT has a good role in promoting the upper limbmotor function of patients who are in the sub-acute phase. Whether the participantsreceived other means of rehabilitation, CIMT has a significant effect on improvinguse of upper extremity in patients.