A Doussoulin*, C Rivas, R Rivas and J Saiz
Background: Constraint-induced movement therapy (CIMT) is a treatment strategy that has been shown to improve the function of an upper limb affected by stroke. Although an extensive corpus of literature supports the positive impact of CIMT on neuroplasticity and the recovery of function, has evaluated CIMT conducted individually. Evidence is limited for the application of a CIMT in a collective modality and investigation is needed. Objective: To determine the effectiveness of a modified version of CIMT as a part of combined or collective treatment, as compared to individual CIMT, in increasing the use and functionality of movement of a paretic upper limb. Methods and subjects: The study was a single-blind, randomized parallel trial. Thirty-six patients who had had a stroke for up to 6 months were randomly divided into two intervention groups. The independent variable was the implementation of collective or individual therapy for 3 h for 10 consecutive days and the dependent variables were amount of use and dexterity of the affected upper extremity in activities of daily life. Dependent variables were evaluated by the Motor Activity Log (MAL) and Action Research Arm test (ARAT), at baseline (pre-intervention evaluation), end (post-intervention evaluation) and six months after intervention (follow-up). Results: By controlling the pre-intervention evaluations, analyses of covariance indicated that both dependent variables presented significant differences and the results were in favor of the group therapy at both the postintervention evaluation and follow-up evaluations. Conclusion: Both types of intervention generated increases in the function and use of the upper extremity, with these increases being higher in the collective modality. The effects of the collective modality were maintained 6 months after the intervention ended.
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