Purpose/Relevance:

Hemiparetic stroke-related upper limb dysfunctions pose a significant challenge to both the hemiparetic stroke survivors and rehabilitation professionals. One of the emerging treatment approaches to improving ipsilateral upper limb function and thereby promoting functional abilities after stroke is the Constraint-Induced Movement Therapy (CIMT). Socio-demographic and clinical characteristics which may influence outcomes of CIMT on upper limb functions have not been well established. This study was designed to investigate influence of socio-demographic and clinical characteristics on outcomes of CIMT for upper limb functions in hemiparetic stroke
survivors.        

Participants/Methods/Analysis:

Consenting, first-incidence stroke survivors were randomised into either CIMT Group (CIMTG;n=30) or Control Group (CG; n=31) using a simple randomisation technique. Information on socio-demographic (age, gender, level of education, socio-economic status) and clinical (type and duration of stroke, side of affectation and handedness) characteristics were documented at baseline. Participants in both groups received routine rehabilitative physiotherapy. In addition, the CIMTG wore purposively fabricated restraints on their unaffected hands for 21 consecutive days (intervention). Both groups performed their routine activities of daily living. Functional Use (FU) and Motor Function (MF) of the affected upper limb were assessed using motor activity log (scored 0 to 5) and motricity index (scored 1 to 100) respectively at baseline, immediate post-intervention and post-intervention follow-up (weeks 2, 4, 6 and 8). Compliance with CIMT was measured using a compliance time log. Data were analysed using descriptive statistics, t-test, Wilcoxon signed rank test, Mann-Whitney U, Pearson’s Coefficient Moment Correlation Method and One way ANOVA at p = 0.05. 

Results:

The CIMTG and CG were comparable in age (56.2 ±12.1; 52.8 ±9.4 years), duration of stroke (3.0 ±3.0; 2.2 ±2.9 years), baseline FU scores (2.03 ±0.4; 2.00 ±0.4) and MF scores (58.6 ±8.0; 56.0 ±5.9) respectively. Post-intervention FU scores were significantly higher than baseline in both groups and significantly more in the CIMTG (2.67 ± 0.54) than in CG (2.39 ± 0.50). There was no significant difference in the post-intervention MF for CIMTG (59.3 ±7.6) and CG (56.2 ± 6.1) compared with baseline. Duration of stroke (r=0.23) and compliance (r=0.32) had no significant correlations with the changes in FU and MF scores from baseline to immediate post-intervention and throughout the 8-week follow-up in the CIMTG. Age had no significant correlation with FU (r=0.11) and MF (r=0.12) in the CIMTG. There were no significant differences in the FU and MF of the participants by gender, type of stroke, side of affectation and handedness post-intervention in the CIMTG. Level of education and socio-economic status also had no significant influence on the changes in FU and MF scores from baseline to post-intervention as well as from baseline to each of weeks 2, 4, 6 and 8 of follow-up.

Conclusion:

Constraint-induced movement therapy resulted in significant improvement in functional use of the affected upper limb of the hemiparetic stroke survivors. However, this improvement was not influenced by the socio-demographic and clinical characteristics of the stroke survivors.