A randomized controlled trial of self-regulated modified constraint-induced movement therapy in sub-acute stroke patients

Background and purpose Emerging research suggests the use of self‐regulation (SR) for improving functional regain in patients post stroke. SR is proposed to produce an added effect to effective modified constraint‐induced movement therapy (mCIMT). This study aimed to examine the effect of a self‐reg...

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Bibliographic Details
Published in:European journal of neurology 2016-08, Vol.23 (8), p.1351-1360
Main Authors: Liu, K. P. Y., Balderi, K., Leung, T. L. F., Yue, A. S. Y., Lam, N. C. W., Cheung, J. T. Y., Fong, S. S. M., Sum, C. M. W., Bissett, M., Rye, R., Mok, V. C. T.
Format: Article
Language:English
Subjects:
Activities of Daily Living
Aged
Female
functional recovery
Humans
Male
Middle Aged
modified constraint-induced movement therapy
Physical Therapy Modalities
randomized controlled trial
Recovery of Function - physiology
Self-Control
self-regulation
Stroke
Stroke - physiopathology
Stroke Rehabilitation
Treatment Outcome
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Summary:Background and purpose Emerging research suggests the use of self‐regulation (SR) for improving functional regain in patients post stroke. SR is proposed to produce an added effect to effective modified constraint‐induced movement therapy (mCIMT). This study aimed to examine the effect of a self‐regulated mCIMT programme (SR‐mCIMT) for functional regain in patients with sub‐acute stroke. Methods Eighty‐six patients completed the trial: SR‐mCIMT, n = 29; mCIMT, n = 31; or conventional functional rehabilitation, n = 26. All interventions were 2‐week therapist‐guided training. Outcome measurements, taken by a blinded assessor, examined arm function [Action Research Arm Test (ARAT), Fugl‐Meyer Assessment (FMA)], daily task performance [Lawton Instrumental Activities of Daily Living Scale (Lawton IADL)] and self‐perceived arm use in functional tasks [Motor Activity Log (MAL)]. Results Significant differences were found with the SR‐mCIMT outperforming the other groups after the intervention (ARAT, P = 0.006; FMA, Lawton IADL and MAL, all Ps < 0.001). In terms of the carry‐over effect, the SR‐mCIMT group outperformed in the hand and coordination subscales of ARAT and FMA (P = 0.012–0.013) and the self‐perceived quality of arm use (P = 0.002). Conclusion A combination of SR and mCIMT could produce an added effect in functional regain in patients post stroke.
ISSN:1351-5101
1468-1331
DOI:10.1111/ene.13037