Home-based constraint-induced movement therapy for patients with upper limb dysfunction after stroke (HOMECIMT): a cluster-randomised, controlled trial

Home-based hand rehabilitation after chronic stroke: Randomized, controlled single-blind trial comparing the MusicGlove with a conventional exercise program

“…For example, one pilot study explored a modified form of constraint-induced movement therapy performed under the supervision of a nonprofessional coach in the home and found similar benefits to the same program performed with a trained therapist in a clinic [14]; a larger study using this protocol found that home-based constraint-induced movement therapy led to significantly greater self-reported use of the impaired limb than conventional therapy [15]. Another common approach is telerehabilitation, which allows a therapist to guide therapy remotely [16].…”

Assessment of the Efficacy of ReoGo-J Robotic Training Against Other Rehabilitation Therapies for Upper-Limb Hemiplegia After Stroke: Protocol for a Randomized Controlled Trial

“…Possible confounding effects of other treatments will be avoided by excluding patients who have received intensive training with an upper-limb training robot or constraint-induced therapy for upper-limb hemiplegia at any time after their stroke, or a botulinum toxin injection within 16 weeks of enrollment. Additionally, before decision-making a participation of study, patients received the standard rehabilitation (physical and occupational therapy) who are not excluded in this study because (1) in study of rehabilitation area for chronic stroke patients, there are few studies that excluse patients receiving the standard rehabilitation before participation of the study from the participant (22–24); (2) in Japan which have health-insurance system that covers all of its citizens, there are few stroke patients in the chronic stroke phase who have not received physical therapy, if they are excluded, the feasibility of this study falls significantly. However, after decision-making a participation of this study, patients were forbidden to receive any other rehabilitation, out of study.…”

Critique of Home Constraint-Induced Movement Therapy Trial

“…The data presented by Barzel et al 4 suggest that it is critical that a skilled therapist, in conjunction with a highly trained nonprofessional coach, who can collaboratively guide the progression, speed, and effort of the patient deliver CIMT interventions at sufficiently high dosage. This and the economic costing of such requirements are crucial information that must inform future trials where modified forms of CIMT or other novel therapies for stroke rehabilitation are tested.…”

“…To remediate these limitations, there have been calls for modified versions of CIMT that are less intensive, lower cost, and easier to deliver. 3 Recent work by Barzel et al 4 attempted to advance the understanding of modified forms of CIMT by applying this therapy in the home setting. Home CIMT includes the basic elements of CIMT including repetitive training, transfer of activities, and constraint of the nonparetic hand.…”

“…However, Home CIMT attempts to accomplish each of these goals within the individual's home setting under the supervision of a nonprofessional coach. 4 Although study participants were involved in overall goal setting for their therapeutic program, they only interacted with professional rehabilitation practitioners (Occupational or Physical Therapists) in 5 visits: 2 initial home visits to set up the program in the first week of a 4-week program and 3 additional sessions to adjust the program during the next 3 weeks. The overall goal was 40 hours of task practice with the paretic arm for a 20-day period.…”