The Mechanism and Clinical Application of Constraint-Induced Movement Therapy in Stroke Rehabilitation

Wang, Dong; Xiang, Junlu; He, Ying; Yuan, Min; Liu, Dong; Ye, Zhenli; Mao, Wei

doi:10.3389/fnbeh.2022.828599

Cited by 13 publications

(13 citation statements)

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“…CI therapy, also known as CIMT, is a neurorehabilitation therapy aimed at recuperating the function of an affected limb after stroke. The affected limb is forced to be used instead of the healthy one ( Wang et al, 2022 ). Many studies have confirmed the efficacy of CIMT in improving limb motor function ( Ju and Yoon, 2018 ; Wang et al, 2022 ).…”

Section: Discussionmentioning

confidence: 99%

“…The affected limb is forced to be used instead of the healthy one ( Wang et al, 2022 ). Many studies have confirmed the efficacy of CIMT in improving limb motor function ( Ju and Yoon, 2018 ; Wang et al, 2022 ). Electroacupuncture therapy combines traditional Chinese medicine acupuncture therapy and Western medicine rehabilitation therapy.…”

Section: Discussionmentioning

confidence: 99%

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Rehabilitation of motor function after stroke: A bibliometric analysis of global research from 2004 to 2022

Zou

Wan

et al. 2022

Front. Aging Neurosci.

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Background and aimsThe mortality rate of stroke has been increasing worldwide. Poststroke somatic dysfunctions are common. Motor function rehabilitation of patients with such somatic dysfunctions enhances the quality of life and has long been the primary practice to achieve functional recovery. In this regard, we aimed to delineate the new trends and frontiers in stroke motor function rehabilitation literature published from 2004 to 2022 using a bibliometric software.MethodsAll documents related to stroke rehabilitation and published from 2004 to 2022 were retrieved from the Web of Science Core Collection. Publication output, research categories, countries/institutions, authors/cocited authors, journals/cocited journals, cocited references, and keywords were assessed using VOSviewer v.1.6.15.0 and CiteSpace version 5.8. The cocitation map was plotted according to the analysis results to intuitively observe the research hotspots.ResultsOverall, 3,302 articles were retrieved from 78 countries or regions and 564 institutions. Over time, the publication outputs increased annually. In terms of national contribution, the United States published the most papers, followed by China, Japan, South Korea, and Canada. Yeungnam University had the most articles among all institutions, followed by Emory University, Fudan University, and National Taiwan University. Jang Sung Ho and Wolf S.L. were the most productive (56 published articles) and influential (cited 1,121 times) authors, respectively. “Effect of constraint-induced movement therapy on upper extremity function 3–9 months after stroke: the Extremity Constraint Induced Therapy Evaluation randomized clinical trial” was the most frequently cited reference. Analysis of keywords showed that upper limbs, Fugl–Meyer assessment, electromyography, virtual reality, telerehabilitation, exoskeleton, and brain–computer interface were the research development trends and focus areas for this topic.ConclusionPublications regarding motor function rehabilitation following stroke are likely to continuously increase. Research on virtual reality, telemedicine, electroacupuncture, the brain–computer interface, and rehabilitation robots has attracted increasing attention, with these topics becoming the hotspots of present research and the trends of future research.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Rehabilitation of motor function after stroke: A bibliometric analysis of global research from 2004 to 2022

Zou

Wan

et al. 2022

Front. Aging Neurosci.

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“…The studies included in this meta-analysis used different CIMT protocol and outcome measures, which may bias of CIMT efficacy assessment. A review ( 64 ) mentioned that differences in the types of restrictions, duration of restriction, intervention time, training intensity, and evaluation methods weaken the evidence for the clinical value of CIMT. First, included studies differed in CIMT intensity (ranging from 30 min to 6 h per day) and duration (ranging from 2 weeks to 3 months) because our inclusion criteria did not limit these parameters.…”

Section: Discussionmentioning

confidence: 99%

Effect of constraint-induced movement therapy on lower extremity motor dysfunction in post-stroke patients: A systematic review and meta-analysis

Zhou

Cui

et al. 2022

Front. Neurol.

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ObjectiveConstraint-induced movement therapy (CIMT) is a common treatment for upper extremity motor dysfunction after a stroke. However, whether it can effectively improve lower extremity motor function in stroke patients remains controversial. This systematic review comprehensively studies the current evidence and evaluates the effectiveness of CIMT in the treatment of post-stroke lower extremity motor dysfunction.MethodsWe comprehensively searched randomized controlled trials related to this study in eight electronic databases (PubMed, Embase, The Cochrane Library, Web of Science, CBM, CNKI, WAN FANG, and VIP). We evaluated CIMT effectiveness against post-stroke lower extremity motor dysfunction based on the mean difference and corresponding 95% confidence interval (95% CI). We assessed methodological quality based on the Cochrane Bias Risk Assessment Tool. After extracting the general information, mean, and standard deviation of the included studies, we conducted a meta-analysis using RevMan 5.3 and Stata 16.0. The primary indicator was the Fugl-Meyer Assessment scale on lower limbs (FMA-L). The secondary indicators were the Berg balance scale (BBS), 10-meter walk test (10MWT), gait speed (GS), 6-min walk test (6MWT), functional ambulation category scale (FAC), timed up and go test (TUGT), Brunnstrom stage of lower limb function, weight-bearing, modified Barthel index (MBI), functional independence measure (FIM), stroke-specific quality of life questionnaire (SSQOL), World Health Organization quality of life assessment (WHOQOL), and National Institute of Health stroke scale (NIHSS).ResultsWe initially identified 343 relevant studies. Among them, 34 (totaling 2,008 patients) met the inclusion criteria. We found that patients treated with CIMT had significantly better primary indicator (FMA-L) scores than those not treated with CIMT. The mean differences were 3.46 (95% CI 2.74–4.17, P < 0.01, I2 = 40%) between CIMT-treated and conventional physiotherapy-treated patients, 3.83 (95% CI 2.89–4.77, P < 0.01, I2 = 54%) between patients treated with CIMT plus conventional physiotherapy and patients treated only with conventional physiotherapy, and 3.50 (95% CI 1.08–5.92, P < 0.01) between patients treated with CIMT plus western medicine therapy and those treated only with western medicine therapy. The secondary indicators followed the same trend. The subgroup analysis showed that lower extremity CIMT with device seemed to yield a higher mean difference in FMA-L scores than lower extremity CIMT without device (4.52, 95% CI = 3.65–5.38, P < 0.01 and 3.37, 95% CI = 2.95–3.79, P < 0.01, respectively).ConclusionCIMT effectively improves lower extremity motor dysfunction in post-stroke patients; however, the eligible studies were highly heterogeneous.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=277466.

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“…One current therapy is known as constraint-induced movement therapy (CIMT), a neurorehabilitative method where the non-paretic limb is immobilized to promote the use of the weakened limb, thus reducing learned non-use. CIMT has been shown to be beneficial in both human and rodent studies [ 2 ]. The constraint of upper-extremity function between 3 and 9 months post stroke and traumatic brain injury (TBI) was shown to improve recovery, with CIMT patients showing improved function compared to patients who did not receive CIMT [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Use of Botulinum Toxin for Limb Immobilization for Rehabilitation in Rats with Experimental Stroke

et al. 2023

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Motor rehabilitation strategies after unilateral stroke suggest that the immobilization of the healthy, unimpaired limb can promote the functional recovery of a paretic limb. In rodents, this has been modeled using casts, harnesses, and other means of restricting the use of the non-paretic forelimb in models of experimental stroke. Here, we evaluated an alternative approach, using botulinum toxin injections to limit the function of the non-paretic forelimb. Adult male rats were subjected to permanent ligation of the left distal middle cerebral artery, resulting in right forelimb paresis. The rats were then subjected to: (1) no treatment; (2) botulinum toxin injections 1 day post stroke; or (3) cast placement 5 days post stroke. Casts were removed after 5 weeks, while the botulinum toxin injection effectively immobilized subjects for approximately the same duration. Rats with bilateral forelimb impairment due to the stroke plus casting or botulinum injections were still able to feed and groom normally. Both immobilization groups showed modest recovery following the stroke compared to those that did not receive immobilization, but the casting approach led to unacceptable levels of animal stress. The botulinum toxin approach to limb immobilization had both advantages and disadvantages over traditional physical limb immobilization. The major advantage was that it was far less stress-inducing to the subject animals and appeared to be well tolerated. A disadvantage was that the paresis took roughly 10 weeks to fully resolve, and any degree of residual paresis could confound the interpretation of the behavioral assessments.

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The Mechanism and Clinical Application of Constraint-Induced Movement Therapy in Stroke Rehabilitation

Cited by 13 publications

References 65 publications

Rehabilitation of motor function after stroke: A bibliometric analysis of global research from 2004 to 2022

Rehabilitation of motor function after stroke: A bibliometric analysis of global research from 2004 to 2022

Effect of constraint-induced movement therapy on lower extremity motor dysfunction in post-stroke patients: A systematic review and meta-analysis

Use of Botulinum Toxin for Limb Immobilization for Rehabilitation in Rats with Experimental Stroke

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