Paretic hand rehabilitation with constraint-induced movement therapy after stroke

Objective: Hemiparesis of the upper limb after stroke can be severely disabling. We studied the effectiveness of constraint-induced movement therapy in improving motor abilities in very chronic stroke subjects. We assessed whether the obtained changes, if any, would endure after the intervention program. Design: Participants were 27 consecutive chronic stroke subjects (mean age, 56 +/- 13 yrs) who fulfilled specific motor criteria. The design was an uncontrolled preintervention to postintervention comparison. The subjects participated in a 2-wk-long constraint-induced movement therapy program. The motor function of the affected arm and its daily use were assessed using a structured motor performance test in a control test 2 wks before the intervention, then again immediately before and after the intervention, and at the follow-up. The intervention was undertaken in a rehabilitation hospital. Results: The motor abilities of the affected arm improved significantly as measured by the structured motor performance test. The obtained improvements in the affected arm motor behavior endured for 5 mos after the therapy. Conclusions: Chronic stroke subjects, who have sufficient residual motor control for exercise, benefit from highly concentrated therapy and can still enhance their voluntary motor control of the affected arm even years after the incident.