Effect of modified constraint-induced movement therapy on the activities of daily living of patients with acute stroke

Objective To observe the rehabilitation effect of modified constraint-induced movement therapy (mCIMT) on activities of daily living (ADL) in patients with acute ischemic stroke.  Methods A total of 60 patients in acute stage of cerebral stroke with limb dysfunction admitted in Ruijin Hospital from December 2012 to May 2013, were randomly divided into routine rehabilitation treatment group (control group, N = 30) and mCIMT group (N = 30). Control group was given routine rehabilitation training, 60 min each time, twice per day, 5 d per week; mCIMT group received mCIMT treatment with the similar frequency. After 2-week training, all patients were transferred to rehabilitation center for 4-week continous training. The total treatment period was 6 weeks. All of those patients received assessment before treatment and 2 weeks, 6 weeks, 12 weeks after treatment on the ability of daily living and motor function, including the modified Barthel Index (mBI), Fugl-Meyer Assessment (FMA) and Berg Balance Scale (BBS).  Results Patients in both groups got increased mBI ( P = 0.004, 0.000, 0.000), FMA (upper limb: P = 0.000, for all) and BBS scores ( P = 0.005, 0.000, 0.000) 2, 6, 12 weeks after treatment. FMA (lower limb) score was increased 6 and 12 weeks after treatment ( P = 0.000, for all). Compared to the control group, patients in mCIMT group got increased mBI ( P = 0.000, for all), FMA (upper limb:  P = 0.000, for all; lower limb:  P = 0.000, for all) and BBS scores ( P = 0.000, for all) 2, 6, 12 weeks after treatment.  Conclusions mCIMT has positive therapeutic effects on the motor function of limbs in hemiplegic patients with stroke in acute stage, which can improve the balance ability and the ability of daily life, so as to raise the quality of life of patients. The efficacy of mCIMT is superior to general routine rehabilitation treatment. DOI: 10.3969/j.issn.1672-6731.2015.04.006