Constraint-induced therapy for stroke: more of the same of something completely different?

The term 'constraint-induced therapy' is used to denote a 'family of treatment modalities' in which the common feature is discouraging the use of the unaffected or less affected arm, combined with intensive training of the paretic arm. A systematic literature search revealed only three randomized controlled studies on the effectiveness of constraint-induced therapy. The results of several systematic reviews on exercise therapy in stroke rehabilitation indicate that more intensive (i.e. more time spent in) training may be beneficial. Therefore, it is not unlikely that any (as yet unproved) effect of constraint-induced techniques is the result of more training, and the answer to the question in the title of this review seems to be 'More of the same'. Curr Opin Neurol 14:741-744. (C) 2001 Lippincott Williams Wilkins.