Effects of Two Different Modes of Task Practice during Lower Limb Constraint-Induced Movement Therapy in People with Stroke: A Randomized Clinical Trial

Abstract

Background. Constraint-induced movement therapy (CIMT) is used for the rehabilitation of motor function after stroke. Objectives. The aim of this study was to compare the effects of lower limb CIMT that uses number of repetition of tasks with the one that uses number of hours of practice. Method. The study was a randomized clinical trial approved by the Ethics Committee of Kano State Ministry of Health. Fifty-eight people with stroke participated in the study. Groups 1 and 2 performed daily 600 repetitions and 3 hours of task practice, respectively, 5 times weekly for 4 weeks. Motor impairment (primary outcome), balance, functional mobility, knee extensor spasticity, walking speed and endurance, and exertion before and after commencement of activities were assessed at baseline and postintervention. The data was analyzed using Friedmann and Mann-Whitney U tests. Result. The results showed that there was only significant difference ( p < 0.05 ) in knee extensor spasticity (group 1 ( median = 0 0 , mean rank = 27.50 ); group 2 ( median = 0 0 , mean rank = 31.64 )), exertion before commencement of activities (group 1 ( median = 0 0.5 , mean rank = 21.90 ); group 2 ( median = 1 0.5 , mean rank = 37.64 )), and exertion after commencement of activities (group 1 ( median = 1 1 , mean rank = 20.07 ); group 2 ( median = 1 0 , mean rank = 39.61 ) postintervention in favour of the experimental group (group 1)). Conclusion. The group 1 protocol is more effective at improving outcomes after stroke.

Effects of Lower Limb Constraint Induced Movement Therapy in People With Stroke: A Systematic Review and Meta-Analysis

“…A total of 16 studies were included in the study (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37). The search of the databases and the reference list of the relevant studies yielded 1,023 hits in which 17 hits were provided from the reference list of the relevant studies.…”

“…The range for the sample size in the studies was between one and 58 participants. However, only four studies reported how the sample size was calculated (22)(23)(24)37). The studies were published between 2005 and 2021.…”

“…The studies were published between 2005 and 2021. Out of the 16 included studies, 10 are RCTs (22,(24)(25)(26)(27)(28)(29)(30)(31)37), and two studies each are either single subject experimental AB designs (32,33); pretest-post-test experimental designs (23,34); and case reports (35,36), respectively. Eight studies included chronic stroke patients (23,24,26,(31)(32)(33)(34)36).…”

“…Two studies included subacute and chronic stroke patients (22,28). Three studies included acute, subacute, and chronic stroke patients (27,30,37). Overall, the range of time since the stroke was 1 week to 6 years.…”

“…One study included participants who had significant walking speed deficits of ≤0.8 m/s (30). Only 11 studies provided information on the types of stroke the participants suffered, 176 ischaemic and 44 haemorrhagic (22,23,25,27,28,30,31,(34)(35)(36)(37). Eight studies used participants with ischaemic and haemorrhagic stroke (22,23,27,28,30,31,34,37).…”