A Clinical and Neurophysiological Study of Constraint Induced Movement Therapy versus Conventional Rehabilitation Therapy in Acute Stroke Patients: Comparative Study

[摘要] Background: Functional impairment of the affected upper extremity is one of the disabling consequences of stroke. Constraint induced movement therapy (CIMT) is considered as a new treatment strategy that might be more effective than conventional rehabilitation treatment. Objective: To assess and compare the efficacy of CIMT and the conventional rehabilitation therapy in improvement of the upper limb in stroke patients both clinically and neurophysiologically by transcranial magnetic stimulation. Methods: This study included twenty stroke patients confirmed by MRI in the distribution of the middle cerebral artery territory. Patients were assessed by Brunstrom-Fugl Meyer test, Action Research Arm test and motor evoked potentials (MEP)s of the affected hand. The clinical and neurophysiological tests were performed initially and after end of rehabilitation.  The patients were divided randomly into two groups; group I: 10 patients were given conventional rehabilitation program for four months, group II: 10 patients were subjected to the CIMT for two hours per day, 5 days per week for two consecutive weeks. Results: group I showed a significant improvement in clinical scores of both tests and MEPs parameters. Group II showed a highly significant improvement in clinical scores of both tests and MEPs parameters. Conclusion: We could conclude that both CIMT and conventional rehabilitation can result in functional improvement. But if we consider the shorter duration needed to achieve the same results using CIMT together with the trend towards a more significant improvement, then CIMT might be a better method to start with. (Egypt J Neurol Psychiat Neurosurg 2010; 47(1): 225-232)

[学科分类] 精神健康和精神病学