Movement Therapy Helps Stroke Patients
Study Shows Long-Term Benefit From Constraint-Induced Movement Therapy
Dec.11, 2007 -- Stroke patients with mild to
moderate impairments can reap long-lasting benefits from a two-week program of
specialized movement therapy, according to a study that tracked them for two
The new study was a continuation of previous research that showed the
patients retained their improvement in upper limb functioning 12 months after
the treatment, called constraint-induced movement therapy.
The most recent study is more good news, according to researcher Steven L.
Wolf, PT, PhD, professor of rehabilitation medicine at the Emory University
School of Medicine, Atlanta. It is published online and in the January issue of
The Lancet Neurology.
"Two weeks of constraint-induced movement therapy given to patients with
mild to moderate stroke has sustainable improvements that are still seen two
years later," Wolf tells WebMD.
How Constraint-Induced Movement Therapy Works
During the treatment, a patient's less-affected wrist and hand are
restrained during most of their waking hours. A therapist guides them in using
the affected limb to practice repetitive tasks that are functionally relevant,
working with them for up to six hours a day.
The treatment differs, Wolf says, from so-called forced-use therapy, in
which the patient uses the impaired limb while the other is restrained but does
not receive formal training.
The new study assesses how well stroke patients enrolled in the EXCITE trial
(extremity constraint-induced movement therapy evaluation) kept the improvement
in movement 24 months after receiving the intensive treatment.
In the trial, 106 of the 222 participants were randomly assigned to the
treatment or to "usual or customary" care, which could include
traditional physical therapy or other measures, Wolf says. The treatment began
three to nine months after the stroke and went on for two weeks.
"There was no formalized training after the two weeks," Wolf says,
although the patients may have continued practicing at home.
Every four months, the patients were evaluated to see how well their
impaired upper limb improved as far as movement ability, quality of life, and
measures such as their willingness to participate socially.
"After one year, the delayed group, or control group, also got
intervention," Wolf says.
At the two-year follow-up, the improvement persisted, Wolf and his
colleagues found. "Strength in their grip and in their ability to lift
weight improved. It was better than at the 12-month mark."
Health-related quality-of-life measures such as social participation