Constraint-induced movement therapy in the treatment of the upper limb after stroke: A meta-analysis of randomized controlled trials / 中华物理医学与康复杂志

ABSTRACT

Objective To evaluate the effectiveness of constraint-induced movement therapy (CIMT),modified CIMT and forced use in the treatment of the upper limbs of adults after stroke. Methods Published ac-counts of trials of these techniques were located through electronic searches of the following databases: PubMed,EBSCO, Ovid, the Cochrane Central Register of Controlled Trails, EMbase, Science Citation Index (Expanded),HighWire Press, CBMDisc, CCTR, CNKI and VIP from the date of establishment of the databases to September 2009. The bibliographies of the articles thus retrieved were also checked. Results A total of 12 trials involving 648 patients were discovered. Meta-analysis showed that CIMT has been shown to increase movement efficiency, reduce normalized movement time, increase use of the more affected arm, improve the quality of use of the more affected arm and reduce the impact of the affected arm. C1MT showed no significant effect in improving independence in daily life compared with traditional rehabilitation. Conclusions To some extent, (modified) CIMT promotes arm rehabilita-tion after stroke effectively. However, these studies were small and their quality was poor. They had different follow-up points, assessed with different rating scales, and the course of stroke in the studies was also different. So more high-quality and large-scale randomized controlled trials are needed.