Abstract
Objective
To evaluate in a preliminary manner the feasibility, safety, and efficacy of Constraint-Induced
Movement therapy (CIMT) of persons with impaired lower extremity use from multiple
sclerosis (MS).
Design
Clinical trial with periodic follow-up for up to 4 years.
Setting
University-based rehabilitation research laboratory.
Participants
A referred sample of ambulatory adults with chronic MS (N=4) with at least moderate
loss of lower extremity use (average item score ≤6.5/10 on the functional performance
measure of the Lower Extremity Motor Activity Log [LE-MAL]).
Interventions
CIMT was administered for 52.5 hours over 3 consecutive weeks (15 consecutive weekdays)
to each patient.
Main Outcome Measures
The primary outcome was the LE-MAL score at posttreatment. Secondary outcomes were
posttreatment scores on laboratory assessments of maximal lower extremity movement
ability.
Results
All the patients improved substantially at posttreatment on the LE-MAL, with smaller
improvements on the laboratory motor measures. Scores on the LE-MAL continued to improve
for 6 months afterward. By 1 year, patients remained on average at posttreatment levels.
At 4 years, half of the patients remained above pretreatment levels. There were no
adverse events, and fatigue ratings were not significantly changed by the end of treatment.
Conclusions
This initial trial of lower extremity CIMT for MS indicates that the treatment can
be safely administered, is well tolerated, and produces substantially improved real-world
lower extremity use for as long as 4 years afterward. Further trials are needed to
determine the consistency of these findings.
Keywords
List of abbreviations:
CIMT (Constraint-Induced Movement therapy), d' (effect size), EDSS (Expanded Disability Status Scale), FP (functional performance), LE-MAL (Lower Extremity Motor Activity Log), LE-MFT (Lower Extremity Motor Function Test), MS (multiple sclerosis), 6MWT (6-minute walk test), T25W (timed 25-foot walk test), VAS (visual analog scale)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 29, 2012
Footnotes
Supported by the National Multiple Sclerosis Society (grant nos. PP 1395, RG 4221) and the National Institutes of Health (grant nos. HD061767, HD053750).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
