Effect of constraint-induced movement therapy on persons-reported outcomes of health status after stroke: a systematic review and meta-analysis
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2021;9(8):20 Int J Rehabil Res. 2021 Mar 1;44(1): 15-23.What this means for my practice?
Results of this meta-analysis may suggest that constraint-induced movement therapy resulted in significantly greater motor function of the upper and lower limb, quality of movement of the upper limb and quantity of movement of the upper limb post-intervention compared to control in post-stroke patients. However, no statistical signfiicant differences in patient-reported health status in the upper and lower limb were observed both post-intervention or at follow-up, as well as in sub-acute and chronic patients. This study was limited by the low number of studies used to analyze several of the outcomes, as well as the heterogeneity in outcome measures and treatment protocols. There is a need for more constraint-induced movement therapy studies to further investigate its efficacy in post-stroke patients.
Zusammenfassung der Studie
Nine studies containing a total of 558 post-stroke patients were included in this meta-analysis comparing constraint-induced movement therapy vs control for the improvement of patient-reported health status and functionality. The pooled outcomes of interest included patient-reported health status of the upper limb and lower limb, motor function of the upper and lower limb, quality and quantity of movement of the upper limb, and activities of daily living of the upper limb. Outcomes were assessed at the post-intervention and follow-up time-points; a sub-group analysis of patients in the subacute and chronic stage was performed for health status of the upper and lower limb at follow up. Results revealed no statistically significant differences in pooled patient-reported health status in the upper limb post-intervention, lower limb post-intervention, lower limb at follow-up, upper and lower limb post-intervention and at follow up, and upper and lower limb at follow up in patients recruited in the subacute and chronic stage (p>0.05 for all). However, pooled motor function post-operation in the upper and lower limb (p=0.02), and quality and quantity of movement in the upper limb post-intervention (p<0.0001 for both) were statistically significantly in favour of the constraint-induced therapy group. Furthermore, no statistical significant difference in the pooled activities of daily living score for the upper limb was observed between the two groups (p=0.42).
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