Norwegian constraint-induced therapy multisite trial: Adherence to treatment protocol applied early after stroke

Stock, Roland; Thrane, Gyrd; Askim, Torunn; Karlsen, Gunn Marte; Langørgen, Eli; Erichsen, Anne Spendrup; Gjone, Ragna Ingeborg; Anke, Audny

doi:10.2340/16501977-2000

Cited by 15 publications

(17 citation statements)

References 30 publications

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“…These kinds of protocols seem to be resource-intensive [ 7 ] and may be difficult to adopt where there are constraints in the availability of staff and service affordability by the patients. Additionally, some studies have reported that the number of hours claimed during CIMT was not completely used for task practice [ 8 – 10 ]. Thus, it is difficult to know how much task or shaping the patients practiced when number of hours is used as a component of dose of task practice.…”

Section: Introductionmentioning

confidence: 99%

Effects of Number of Repetitions and Number of Hours of Shaping Practice during Constraint-Induced Movement Therapy: A Randomized Controlled Trial

Abdullahi

2018

Neurology Research International

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Background Constraint-induced movement therapy (CIMT) is effective in improving motor outcomes after stroke. However, its existing protocols are resource-intensive and difficult to implement. The aim of this study is to design an easier CIMT protocol using number of repetitions of shaping practice. Method The study design was randomized controlled trial. Participants within 4 weeks after stroke were recruited at Murtala Muhammad Specialist Hospital. They were randomly assigned to groups A, B, C, and D. Group A received 3 hours of traditional therapy. Groups B, C, and D received modified CIMT consisting of 3 hours of shaping practice per session, 300 repetitions of shaping practice in 3 sessions, and 600 repetitions of shaping practice in 3 sessions per day, respectively, and constraint for 90% of the waking hours. All treatment protocols were administered 5 times per week for 4 weeks. The primary outcome was measured using upper limb Fugl-Meyer assessment, while the secondary outcome was measured using motor activity log, Wolf Motor Function Test, and upper limb self-efficacy test at baseline, 2 weeks, and 4 weeks after intervention. Result There were 48 participants 4 weeks after intervention. The result showed that there was no significant difference between groups at baseline (p > 0.05). Within-group improvements attained minimal clinically important difference (MCID) in modified CIMT and 300 repetitions and 600 repetitions groups. Conclusion Number of repetitions of shaping practice significantly improved motor function, real-world arm use, and upper limb self-efficacy after stroke. Therefore, it seems to be a simple alternative for the use of number of hours. Trial Registration This trial is registered with Pan African Clinical Trial Registry (registration number: PACTR201610001828172) (date of registration: 21/10/2016).

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Section: Introductionmentioning

confidence: 99%

Effects of Number of Repetitions and Number of Hours of Shaping Practice during Constraint-Induced Movement Therapy: A Randomized Controlled Trial

Abdullahi

2018

Neurology Research International

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“…The mean daily adherence in the early intervention group was 164.4 min ( SD 18.8) or 91.3% of the intended treatment time (Stock et al, ), whereas that in the delayed intervention group was 157.8 min ( SD 13.6) or 87.7% of the intended treatment time.…”

Section: Resultsmentioning

confidence: 99%

“…The therapist responsible for the intervention attended a 4‐day training programme on the study procedures. Further details of the treatment protocol have been described elsewhere (Stock et al, ).…”

Section: Methodsmentioning

confidence: 99%

Early versus late‐applied constraint‐induced movement therapy: A multisite, randomized controlled trial with a 12‐month follow‐up

Stock

Thrane

Anke

et al. 2017

Physiotherapy Res Intl

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“…One of the concerns about the standard CIMT is the issue of compliance since it seems to have a long duration of tasks/shaping practice of 6 h or less [51]. However, studies such as those by Kaplon and his colleagues and Stock and his colleagues have all indicated that the time spent practicing task/shaping fell short of what is being claimed [52,53]. Additionally, many studies have shown that the shorter duration CIMT, the protocol that uses less than or 3 h of task/shaping practice, provides better outcomes [54,55].…”

Section: Protocols Of Constraint-induced Movement Therapymentioning

confidence: 99%

Movement Rehabilitation in Physiotherapy after Stroke: The Role of Constraint-Induced Movement Therapy

Abdullahi¹

2019

Different Areas of Physiotherapy

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Stroke is increasingly becoming a global health problem. This is because it may lead to death, Long-term disability such as in motor function, and significant burden to the patients and their families. The disability can be prevented or rehabilitated using a physiotherapy technique known as constraint-induced movement therapy (CIMT). The CIMT comprises of task practice with the affected limb, constraint of the unaffected limb, and transfer package to foster compliance and increase the amount of task repetition. It helps to reestablish normal motor control through facilitating changes in physiological functions of the brain, improvement in realworld arm use, and movement precision and quality. However, its protocols vary. Some protocols use number of hours and others use number of repetitions to determine the intensity or the amount of task practice. This chapter argued that CIMT is effective, but the protocols that use a number of hours of task practice are not clear and are resource intensive; and as such they could interfere with the process of clinical decision making. Consequently, it proposed the use of a number of repetitions of task practice to determine the intensity or the amount of task practice and extending the application of CIMT to those with severe impairments after stroke. Different Areas of Physiotherapy 2 movement therapy: the future perspective. Information from all the sections to be discussed is needed by the physiotherapist in order to be able to make an effective clinical decision during application of CIMT in people with stroke.

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Norwegian constraint-induced therapy multisite trial: Adherence to treatment protocol applied early after stroke

Abstract: Overall adherence was good; however, time spent in motor activity was only one-third of total treatment time. The parameters in the constraint-induced movement therapy protocol should be individually adjusted early after stroke.

Cited by 15 publications

References 30 publications

Effects of Number of Repetitions and Number of Hours of Shaping Practice during Constraint-Induced Movement Therapy: A Randomized Controlled Trial

Effects of Number of Repetitions and Number of Hours of Shaping Practice during Constraint-Induced Movement Therapy: A Randomized Controlled Trial

Early versus late‐applied constraint‐induced movement therapy: A multisite, randomized controlled trial with a 12‐month follow‐up

Movement Rehabilitation in Physiotherapy after Stroke: The Role of Constraint-Induced Movement Therapy

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