Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 8 , Pages 964-970 , August 2007

Kinematic and Clinical Analyses of Upper-Extremity Movements After Constraint-Induced Movement Therapy in Patients With Stroke: A Randomized Controlled Trial

  • Ching-yi Wu, ScD, OTR

      Affiliations

    • Graduate Institute of Clinical Behavioral Science and Department of Occupational Therapy, Chang Gung University, Tao-yuan, Taiwan
  • ,
  • Chia-ling Chen, MD, PhD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Tao-yuan, Taiwan
  • ,
  • Simon F. Tang, MD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Tao-yuan, Taiwan
  • ,
  • Keh-chung Lin, ScD, OTR

      Affiliations

    • School of Occupational Therapy, College of Medicine, and Neurobiology and Cognitive Science Center, National Taiwan University, and Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
    • Corresponding Author InformationReprint requests to Keh-chung Lin, ScD, OTR, Sch of Occupational Therapy, College of Medicine, National Taiwan University and Dept of Physical Medicine and Rehabilitation, National Taiwan University Hospital, 17, F4, Xu Zhou Rd, Taipei, Taiwan 100
  • ,
  • Ya-ying Huang, MS

      Affiliations

    • Department of Occupational Therapy, Jianan Mental Hospital, Tainan, Taiwan.

References 

  1. Langhorne P, Legg L. Evidence behind stroke rehabilitation. J Neurol Neurosurg Psychiatry. 2003;74(Suppl IV):18–21
  2. Hakkennes S, Keating JL. Constraint-induced movement therapy following stroke: a systematic review of randomized controlled trials. Austr J Physiother. 2005;51:221–231
  3. van der Lee JH, Wagenaar RC, Lankhorst GJ, Vogelaar TW, Deville WL, Bouter LM. Forced use of the upper extremity in chronic stroke patients: results from a single-blind randomized clinical trial. Stroke. 1999;30:2369–2375
  4. Taub E, Uswatte G, Elbert T. New treatments in neurorehabilitation founded on basic research. Nat Rev Neurosci. 2002;3:228–236
  5. Wolf SL, Winstein CJ, Miller JP, et al. Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke: the EXCITE randomized clinical trial. JAMA. 2006;296:2095–2104
  6. Page SJ, Levine P, Sisto S, Bond Q, Johnston MV. Stroke patients’ and therapists’ opinions of constraint-induced movement therapy. Clin Rehabil. 2002;16:55–60
  7. Page SJ, Sisto S, Levine P, Johnston MV, Hughes M. Modified constraint induced therapy: a randomized feasibility and efficacy study. J Rehabil Res Dev. 2001;38:583–590
  8. Page SJ, Sisto S, Levine P, McGrath RE. Efficacy of modified constraint-induced movement therapy in chronic stroke: a single-blinded randomized controlled trial. Arch Phys Med Rehabil. 2004;85:14–18
  9. Sterr A, Freivogel S. Motor-improvement following intensive training in low-functioning chronic hemiparesis. Neurology. 2003;61:842–844
  10. Atteya AA. Effects of modified constraint induced therapy on upper limb function in subacute stroke patients. Neuroscience. 2004;9:24–29
  11. Page SJ, Sisto S, Johnston MV, Levine P. Modified constraint-induced therapy after subacute stroke: a preliminary study. Neurorehabil Neural Repair. 2002;16:290–295
  12. Page SJ, Levine P, Leonard AC. Modified constraint-induced therapy in acute stroke: a randomized controlled pilot study. Neurorehabil Neural Repair. 2005;19:27–32
  13. Dromerick AW, Edwards DF, Hahn M. Does the application of constraint-induced movement therapy during acute rehabilitation reduce arm impairment after ischemic stroke?. Stroke. 2000;31:2984–2988
  14. Boake C, Noser EA, Ro T, et al. Constraint-induced movement therapy during early stroke rehabilitation. Neurorehabil Neural Repair. 2007;21:14–24
  15. Alberts JL, Butler AJ, Wolf SL. The effects of constraint-induced therapy on precision grip: a preliminary study. Neurorehabil Neural Repair. 2004;18:250–258
  16. Sunderland A, Tuke A. Neuroplasticity, learning and recovery after stroke: a critical evaluation of constraint-induced therapy. Neuropsychol Rehabil. 2005;15:81–96
  17. Roby-Brami A, Feydy A, Combeaud M, Biryukova EV, Bussel B, Levin MF. Motor compensation and recovery for reaching in stroke patients. Acta Neurol Scand. 2003;107:369–381
  18. Mccrea PH, Eng JJ, Hodgson AJ. Biomechanics of reaching: clinical implications for individuals with acquired brain injury. Disabil Rehabil. 2002;24:534–541
  19. Lang CE, Wagner JM, Dromerick AW, Edwads DF. Measurement of upper-extremity function early after stroke: properties of the Action Research Arm Test. Arch Phys Med Rehabil. 2006;87:1605–1610
  20. Jeannerod M. The neural and behavioural organization of goal-directed movements. New York: Oxford Univ Pr; 1988;
  21. Milner TE. A model for the generation of movements requiring endpoint precision. Neuroscience. 1992;49:487–496
  22. Haaland KY, Prestopnik JL, Knight RT, Lee RR. Hemispheric asymmetries for kinematic and positional aspects of reaching. Brain. 2004;127:1145–1158
  23. Hakim RM, Kelly SJ, Grant-Beuttler M, Healy B, Krempasky J, Moore S. Case report: a modified constraint-induced therapy (mCIT) program for the upper extremity of a person with chronic stroke. Physiother Theory Pract. 2005;21:243–256
  24. Brunnstrom S. Movement therapy in hemiplegia. New York: Harper & Row; 1970;
  25. Taub E, Miller NE, Novack TA, et al. Technique to improve chronic motor deficit after stroke. Arch Phys Med Rehabil. 1993;74:347–354
  26. Teng EL, Chui HC. The modified Mini-Mental State (3MS) Exam. J Clin Psychiatry. 1987;48:314–318
  27. Fugl-Meyer AR, Jaasko L, Leyman I, Olsson S, Steglind S. The post-stroke hemiplegic patient (I. A method for evaluation of physical performance). Scand J Rehabil Med. 1975;7:13–31
  28. Duncan PW, Propst M, Nelson SG. Reliability of the Fugl-Meyer assessment of sensorimotor recovery following cerebrovascular accident. Phys Ther. 1983;63:1606–1610
  29. DiFabio RP, Badke RB. Relationship of sensory organization to balance function in patients with hemiplegia. Phys Ther. 1990;70:542–548
  30. Taub E, Morris D, Bowman M, Delgado A, Uswatte G. [manual] Upper-Extremity Motor Activity Log. Birmingham: Psychology Dept, Univ Alabama; 2000;
  31. Kamper DG, McKenna-Cole AN, Kahn LE, Reinkensmeyer DJ. Alterations in reaching after stroke and their relation to movement direction and impairment severity. Arch Phys Med Rehabil. 2002;83:702–707
  32. Ma HI, Trombly CA, Tickle-Degnen L, Wagenaar RC. Effect of one single auditory cue on movement kinematics in patients with Parkinson’s disease. Am J Phys Med Rehabil. 2004;83:530–536
  33. Stevens JP. Applied multivariate statistics for the social sciences. 4th ed.. Mahwah: Lawrence Erlbaum Associates; 2002;
  34. Rosenthal R, Rosnow RL. Essentials of behavioral research: methods and data analysis. 2nd ed.. New York: McGraw-Hill; 1991;
  35. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed.. Hillsdale: Lawrence Erlbaum Associates; 1988;
  36. Cirstea MC, Ptito A, Levin MF. Arm reaching improvements with short-term practice depend on the severity of the motor deficit in stroke. Exp Brain Res. 2003;152:476–488
  37. Sabes PN. The planning and control of reaching movements. Curr Opin Neurobiol. 2000;10:740–746
  38. Archambault P, Pigeon P, Feldman AG, Levin MF. Recruitment and sequencing of different degrees of freedom during pointing movements involving the trunk in healthy and hemiparetic subjects. Exp Brain Res. 1999;126:55–67
  39. Boniface SJ. Plasticity after acute ischaemic stroke studied by transcranial magnetic stimulation. J Neurol Neurosurg Psychiatry. 2001;71:713–715
  40. Hamzei F, Liepert J, Dettmers C, Weiller C, Rijntjes M. Two different reorganization patterns after rehabilitative therapy: an exploratory study with fMRI and TMS. Neuroimage. 2006;31:710–720
  41. Levy CE, Nichols DS, Schmalbrock PM, Keller P, Chakeres DW. Functional MRI evidence of cortical reorganization in upper-limb stroke hemiplegia treated with constraint-induced movement therapy. Am J Phys Med Rehabil. 2001;80:4–12
  42. Schaechter JD, Kraft E, Hilliard TS, et al. Motor recovery and cortical reorganization after constraint-induced movement therapy in stroke patients: a preliminary study. Neurorehabil Neural Repair. 2002;16:326–338
  43. Kim YH, Park JW, Ko MH, Jang SH, Lee PK. Plastic changes of motor network after constraint-induced movement therapy. Yonsei Med J. 2004;45:241–246
  44. Kwakkel G, Kollen BJ, Wagenaar RC. Long term effects of intensity of upper and lower limb training after stroke: a randomised trial. J Neurol Neurosurg Psychiatry. 2002;72:473–479

 Supported by the National Health Research Institutes (grant nos. NHRI-EX94-9103EC, NHRI-EX95-9103EC), Medical Research Center at Chang Gung Memorial Hospital (grant no. CMRPD32022), and the National Science Council, Taiwan (grant no. NSC 92-2314-B-002-139).

 No commercial party having a direct financial interest in the results of 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.

PII: S0003-9993(07)00355-3

doi: 10.1016/j.apmr.2007.05.012

Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 8 , Pages 964-970 , August 2007