Effectiveness of constraint-induced therapy modified recovery quantity and quality of movement of the upper extremity after a stroke

Introduction: Constraint-induced therapy (CIT) is a therapeutic strategy that has been show to improve the function of the upper limb affected by a stroke. Although an extensive body of literature supports the positive impact of CIT on neuroplasticity and the recovery of function, most research has evaluated an individual mode of delivery. However, evidence is limited for the application of CIT protocol in a group setting. Objective: To determine the effectiveness of a modified version of CIT in a group setting as compared to individual, one-on-one basis on the quantity and quality of movement of the paretic upper limb. Methods: Forty participants, 6-60 months post stroke, were randomized into either a group or individual application of CIT. The hemiparetic upper extremity quantity and quality of movement was evaluated using the self-reported, Motor Activity Log and each participant's clinical record at baseline, pre-treatment and post-treatment. Results: The data were analyzed through an analysis of variance with a mixed factorial design 2 x 2. Both groups tended to improve their scores between baseline and pre-treatment measurement, however, no significant effect was found between groups for this time period. Conversely, group differences were seen between pre and post treatment evaluations. Conclusion: This clinical trial provides evidence supporting the application of CIT delivered in a group mode for 3 hours, to improve the performance of the paretic upper limb in daily activities. However the evidence is still limited in relation to this mode CIT version.