Affiliations: Department of Primary Medical Care, University Medical
Center Hamburg-Eppendorf, Hamburg, Germany | Department of Physiotherapy, University Medical Center
Hamburg-Eppendorf, Hamburg, Germany | Department of Neurology, Kliniken Schmieder,
Allensbach, Germany | Department of Neurology, University Clinic Freiburg,
Freiburg, Germany
Note: [] Corresponding author: Anne Barzel, MD, Department of Primary
Medical Care, University Medical Center Hamburg-Eppendorf, Martinistraße
52 20246 Hamburg, Germany. Tel.: +49 40 7410 52400; Fax: +49 40 7410 53615;
E-mail: a.barzel@uke.de
Abstract: Several studies showed that Constraint-Induced Movement Therapy
(CIMT) leads to a lasting improvement of upper extremity function in chronic
stroke patients. The original technique includes an intensive 2-week program
with 6 hours of daily physiotherapy. Due to high expenses it is difficult to
implement this concept in outpatient care. Purpose: The objective of this study was to evaluate the effects of
a 4-week homebased CIMT program among chronic stroke patients and to compare
them with a 2-week CIMT program, based on the original technique. Methods: Seven adults with chronic stroke completed a newly
developed variant of CIMT, performed at patients' homes (group1, CIMThome),
supervised by an instructed family member, constraint of unaffected hand for a
target of 60% of waking hours. The intervention was analysed with pre-,
post-treatment and 6-month follow-up measurements. Effects on improvement in
upper extremity function were compared with patients treated according to the
original protocol (group2, CIMTclassic), supervised by a physiotherapist,
constraint of unaffected hand for a target of 90% of waking hours. Results: Patients from both groups showed almost identical
improvement of their motor function according to scores on the Wolf Motor
Function Test (WMFT) and the Motor Activity Log (MAL) immediately after the
treatment period as well as at follow-up after 6 months. Conclusions: Our study suggests that CIMThome is not only feasible
but also as effective as CIMTclassic. This finding should be replicated in a
larger prospective randomized trial to perform a non-inferiority analysis.
Keywords: Stroke, rehabilitation, constraint-Induced movement therapy
