Timing and Dose of Constraint-Induced Movement Therapy after Stroke: A Systematic Review and Meta-Regression

被引:4
作者
Yang, Yu-Kai [1 ]
Lin, Chieh-Yu [2 ]
Chen, Po-Huang [3 ]
Jhou, Hong-Jie [4 ,5 ]
机构
[1] Changhua Christian Hosp, Dept Phys Med & Rehabil, Changhua 500209, Taiwan
[2] Changhua Christian Hosp, Dept Med Educ, Div Gen Practice, Changhua 500209, Taiwan
[3] Triserv Gen Hosp, Natl Def Med Ctr, Dept Internal Med, Taipei 114, Taiwan
[4] Changhua Christian Hosp, Dept Neurol, Changhua 500209, Taiwan
[5] Kaohsiung Med Univ, Sch Med, Kaohsiung 807, Taiwan
关键词
constraint-induced movement therapy (CIMT); stroke; cognitive function; moto activity log; Fugl-Meyer assessment; wolf motor function test; UPPER EXTREMITY FUNCTION; MOTOR FUNCTION; CONVENTIONAL THERAPY; SUBACUTE STROKE; POST-STROKE; REHABILITATION; METAANALYSIS; RELIABILITY; RECOVERY; LIMB;
D O I
10.3390/jcm12062267
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The aim of this study is to investigate the effects of constraint-induced movement therapy on stroke patients who had intact cognition and some voluntary finger extension and to identify optimal protocols to apply this therapy method. We searched PubMed, Cochrane Library, and Embase for randomized controlled trials conducted prior to January 2022. The outcomes included the Motor Activity Log, Fugl-Meyer Assessment, and Wolf Motor Function Test. The inverse variance method fixed-effect model as well as the DerSimonian and Laird estimator random-effects model were applied, and the mean difference was calculated with 95% confidence interval to measure continuous outcomes. Six randomized controlled trials involving a total of 169 patients with stroke were enrolled. Compared with conventional rehabilitation methods, there was no significant effect of constraint-induced movement therapy when evaluated by the Motor Activity Log, including the amount of use (random-effect, standardized mean difference 0.65; 95%, confidence interval: -0.23-1.52) and quality of movement (random-effect, standardized mean difference 0.60; 95% confidence interval: -0.19-1.39). However, among patients with chronic stroke symptoms, meta-regression analyses showed better performance with a constraint time of at least 6 h per day and 6 h training per week when assessing the amount of use (p = 0.0035) and quality of movement (p = 0.0031). Daily intervention time did not lead to a significant difference in functional upper limb performance. An efficient protocol of constraint-induced movement therapy designed as 6 h of training per week with 6 h constraint per day could bring significant stroke symptom improvement to patients with chronic stroke.
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页数:14
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共 55 条
[1]  
Abu Tariah H, 2010, INT J THER REHABIL, V17, P638
[2]  
[Anonymous], EFF MOD CONSTR IND M
[3]  
[Anonymous], ROB MOD CONSTR IND T
[4]   Kinematic Analysis of the Upper Limb Motor Strategies in Stroke Patients as a Tool towards Advanced Neurorehabilitation Strategies: A Preliminary Study [J].
Aprile, Irene ;
Rabuffetti, Marco ;
Padua, Luca ;
Di Sipio, Enrica ;
Simbolotti, Chiara ;
Ferrarin, Maurizio .
BIOMED RESEARCH INTERNATIONAL, 2014, 2014
[5]   How to perform a meta-analysis with R: a practical tutorial [J].
Balduzzi, Sara ;
Ruecker, Gerta ;
Schwarzer, Guido .
EVIDENCE-BASED MENTAL HEALTH, 2019, 22 (04) :153-160
[6]   Modified Constraint-Induced Movement Therapy is a feasible and potentially useful addition to the Community Rehabilitation tool kit after stroke: A pilot randomised control trial [J].
Baldwin, Cathryn R. ;
Harry, Amy J. ;
Power, Lynda J. ;
Pope, Katherine L. ;
Harding, Katherine E. .
AUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, 2018, 65 (06) :503-511
[7]   Agreed Definitions and a Shared Vision for New Standards in Stroke Recovery Research: The Stroke Recovery and Rehabilitation Roundtable Taskforce [J].
Bernhardt, Julie ;
Hayward, Kathryn S. ;
Kwakkel, Gert ;
Ward, Nick S. ;
Wolf, Steven L. ;
Borschmann, Karen ;
Krakauer, John W. ;
Boyd, Lara A. ;
Carmichael, S. Thomas ;
Corbett, Dale ;
Cramer, Steven C. .
NEUROREHABILITATION AND NEURAL REPAIR, 2017, 31 (09) :793-799
[8]   Efficacy and safety of very early mobilisation within 24 h of stroke onset (AVERT): a randomised controlled trial [J].
Bernhardt, Julie ;
Langhorne, Peter ;
Lindley, Richard I. ;
Thrift, Amanda G. ;
Ellery, Fiona ;
Collier, Janice ;
Churilov, Leonid ;
Moodie, Marjory ;
Dewey, Helen ;
Donnan, Geoffrey .
LANCET, 2015, 386 (9988) :46-55
[9]   Mild dementia or cognitive impairment: The Modified Mini-Mental State Examination (3MS) as a screen for dementia [J].
Bland, RC ;
Newman, SC .
CANADIAN JOURNAL OF PSYCHIATRY-REVUE CANADIENNE DE PSYCHIATRIE, 2001, 46 (06) :506-510
[10]   Is modified constraint-induced movement therapy more effective than bimanual training in improving arm motor function in the subacute phase post stroke? A randomized controlled trial [J].
Brunner, Iris Charlotte ;
Skouen, Jan Sture ;
Strand, Liv Inger .
CLINICAL REHABILITATION, 2012, 26 (12) :1078-1086