A Randomized Controlled Trial of Modified Constraint-Induced Movement Therapy for Elderly Stroke Survivors: Changes in Motor Impairment, Daily Functioning, and Quality of Life
Abstract
Wu C-Y, Chen C-L, Tsai W-C, Lin K-C, Chou S-H. A randomized controlled trial of modified constraint-induced movement therapy for elderly stroke survivors: changes in motor impairment, daily functioning, and quality of life.
Objective
To examine the benefits of modified constraint-induced movement therapy (mCIMT) on motor function, daily function, and health-related quality of life (HRQOL) in elderly stroke survivors.
Design
Two-group randomized controlled trial, with pretreatment and posttreatment measures.
Setting
Rehabilitation clinics.
Participants
Twenty-six elderly stroke patients (mean age, 72y) with 0.5 to 31 months postonset of a first-ever cerebrovascular accident.
Interventions
Twenty-six patients received either mCIMT (restraint of the unaffected limb combined with intensive training of the affected limb) or traditional rehabilitation for a period of 3 weeks.
Main Outcome Measures
Outcome measures included the Fugl-Meyer Assessment (FMA), FIM instrument, Motor Activity Log (MAL), and Stroke Impact Scale (SIS). The FMA evaluated the severity of motor impairment; the FIM instrument and MAL reported daily function; and the SIS detected HRQOL.
Results
The mCIMT group exhibited significantly greater improvements in motor function, daily function, and the physical domain of HRQOL than the traditional rehabilitation group. Patients in the mCIMT group perceived significantly greater percent of recovery after treatment than patients in the traditional rehabilitation group.
Conclusions
These findings suggest mCIMT is a promising intervention for improving motor function, daily function, and physical aspects of HRQOL in elderly patients with stroke. The mCIMT was well tolerated by the elderly patients even though it is a rigorous training program.
aGraduate Institute of Clinical Behavioral Science and Department of Occupational Therapy, Chang Gung University, Tao-yuan, Taiwan
bDepartment of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Tao-yuan, Taiwan
cSchool of Occupational Therapy, College of Medicine, National Taiwan University, and Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
Correspondence to Keh-chung Lin, ScD, OTR, Sch of Occupational Therapy, College of Medicine, National Taiwan University and Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, 17, F4, Xu Zhou Rd, Taipei, Taiwan 100
Supported by the National Health Research Institutes (grant no. NHRI-EX95-9103EC) and the National Science Council (grant no. NSC 93-2314-B-002-116).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
ABSTRACT