Constraint induced movement therapy does not produce clinically significant improvement in upper limb function following stroke.

Prepared by:

Natasha Lannin, University of Western Sydney

Kathryn Thorpe, University of Western Sydney

Belinda Armstrong, Royal Rehabilitation Centre Sydney

Date:

Reviewed February 2004 (Original CAT conducted October 2002).

Review Date:

February 2005

Clinical Question:

What is the evidence that constraint-induced movement training of the upper limb is more effective than any other movement training for adults following stroke?

Clinical Scenario:

Constraint-induced movement therapy (CIM) is a relatively new but intense therapy protocol. Essentially a
CIM approach to upper extremity therapy discourages the use of the unaffected (normal) arm and encourages the use of the hemiplegic arm in order to maximise function. What is the effectiveness of this intervention in training upper limb functional movement, and is it more effective than other movement training approaches?

Clinical Bottom Line:

Constraint-induced movement therapy provides a small, positive effect (neither statistically nor clinically
significant) on upper limb function in patients who require upper limb training for hemiplegia following stroke, however existing studies have only compared its effectiveness to compensatory or bimanual training techniques (and not to techniques designed to practice retraining isolated active movement in the hemiplegic arm).

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