1. Motor control area is dead.
2. Pre-motor control area is dead.
3. Underlying white matter to these areas is dead.
4. Executive control in starting the movement is dead.
http://www.ncbi.nlm.nih.gov/pubmed/27123790
Abstract
Constraint-induced
movement therapy (CIMT) is a neurorehabilitation technique designed to
improve upper extremity motor functions after stroke. This review aimed
to investigate evidence of the effect of CIMT on upper extremity in
stroke patients and to identify optimal methods to apply CIMT. Four
databases (MEDLINE, EMBASE, CINHAL, and PEDro) and reference lists of
relevant articles and reviews were searched. Randomized clinical trials
that studied the effect of CIMT on upper extremity outcomes in stroke
patients compared with other rehabilitative techniques, usual care, or
no intervention were included. Methodological quality was assessed using
the PEDro score. The following data were extracted for each trial:
patients' characteristics, sample size, eligibility criteria, protocols
of CIMT and control groups, outcome measurements, and the PEDro score. A
total of 38 trials were identified according to the inclusion criteria.
The trials included were heterogeneous in CIMT protocols, time since
stroke, and duration and frequency of treatment. The pooled
meta-analysis of 36 trials found a heterogeneous significant effect of
CIMT on upper extremity. There was no significant effect of CIMT at
different durations of follow-up. The majority of included articles did
not fulfill powered sample size and quality criteria. The effect of CIMT
changed in terms of sample size and quality features of the articles
included. These meta-analysis findings indicate that evidence for the
superiority of CIMT in comparison with other rehabilitative
interventions is weak. Information on the optimal dose of CIMT and
optimal time to start CIMT is still limited.
- PMID:
- 27123790
- [PubMed - as supplied by publisher]
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