Tuesday, October 22, 2019

Constraint-Induced Movement Therapy, a New Treatment Approach Regarding Recovery of Motor Function and Dexterity of the Upper Paretic Limb in Stroke Patients: A systematic Review of Randomized Controlled Trials

'May improve' is not good enough. You don't tell us objectively who can benefit. I have way too much dead area to ever benefit from this. I would have ripped off the mitt immediately since I wouldn't be able to do one damn thing. No eating, no dressing, no pissing. 

None of the four outcome measurement tools are objective so absolutely nothing here is repeatable on demand.

Constraint-Induced Movement Therapy, a New Treatment Approach Regarding Recovery of Motor Function and Dexterity of the Upper Paretic Limb in Stroke Patients: A systematic Review of Randomized Controlled Trials

 Giorrdani Queiroz de Souza & Ananiele Lima Carvalho
Hogeschool van Amsterdam – European School of Physiotherapy

ABSTRACT

Objective:
investigate whether Constraint-Induced Movement Therapy is more effective than conventionalneurological treatment approaches in restoring motor function and dexterity of the paretic upper limb in chronicstroke patients.
Method:
a comprehensive electronic search of the complete holdings of MEDLINE, CINAHL, EMBASE,MEDSCAPE, Cochrane Library, PUBMED, and PEDro to January 2006 was conducted. Eleven randomised controlled trials were identified as eligible and relevant data was extracted by two independent reviewers. The effect sizes were calculated and results were pooled where possible. Method quality of the trials was assessed using the PEDro scale, and had a mean score of 8 (ranging between six and nine). Eleven RCTs comparedCIMT to an alternative treatment and/or no treatment. Studies with acute, sub acute and chronic stroke patients were included. Effect sizes could be estimated for all eleven trials.
Results:
data analysis indicates significant improvement in favour of CIMT in all of those studies for at least oneoutcome measure of upper limb function. The pooled standardised mean difference could be calculated for four outcome measurement tools (Action Research Action Test, Wolf Motor Function Test, Fügl-Meyer Assessment,and Motor Activity LOG) producing moderate to large effect sizes, but only one of them attained statistical significance (ARA).
Conclusion
: The statistical analysis indicates that CIMT may improve upper limb motor function and dexterityfollowing stroke for some patients when compared to traditional or no treatment. In order to evaluate the efficacyof different CIMT protocols on different stroke populations and to assess its impact on quality of life, it is of utmost importance the performance of rigorous evaluation of technique using well-designed and larger sample sized trials.

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