http://nnr.sagepub.com/content/27/7/654.abstract?etoc
Abstract
Objective. This study examines performance of Wolf Motor Function Test (WMFT) tasks in terms of the ability of EXCITE trial participants
(who had suffered a stroke 3-9 months before recruitment) to complete the task within the timed interval. Methods.
Data were collected from participants who received constraint-induced
movement therapy (CIMT) 3 to 9 months poststroke (CIMT-I,
n = 106) or 15 to 21 months poststroke (CIMT-D, n =
116). Performance on the 15 timed WMFT tasks was converted into binary
values, and changes in completion of the tasks were
analyzed with generalized estimating equation methods, under the
assumption
of a binomial or Poisson process for completion. Results. During CIMT, the CIMT-I group showed significant within-group improvements in 3 fine-movement tasks and in total noncompleted
tasks (noncompletes), whereas the CIMT-D group did not (P
≤ .0036). CIMT-I improvement was significantly greater than CIMT-D
improvement for the lifting pencil task and total noncompletes.
During the year following CIMT, neither group
showed significant changes in completion of WMFT tasks. Over all time
intervals,
only the CIMT-I group displayed significant
improvement in several tasks and total noncompletes. Between groups,
there were
significant and almost-significant differences
between the improvements of the 2 groups in 3 tasks requiring fine
distal movement.
Conclusion. Receiving CIMT earlier appears
to improve reacquisition and retention of WMFT tasks, especially those
requiring fine motor
skills. Combined with earlier findings, these
results indicate that improvements in existing motor abilities are
possible
with both immediate and delayed CIMT, but early
CIMT is necessary for significant reacquisition of tasks.
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