Effectiveness of constraint-induced movement therapy (CIMT) as home-based therapy on Barthel Index in patients with chronic stroke

Objective: The goal of this study is to investigate the effectiveness of constraint-induced movement therapy (CIMT) on the Barthel Index (BI) scores in persons with stroke to assess dependency in survivers of stroke and to investigate the longterm effects of CIMT on dependency needs as measured by the BI, based on the hypothesis that CIMT as home-based therapy would be of significant benefit in stroke rehabilitation. Methods: Twenty-seven participants, 16 men with a mean age of 58 (± 10.8) and 4 women with a mean age of 60 (± 6.3), participated in the study as an experimental group, and 17 participants, 12 men with a mean age of 58 (± 9.7) and 5 women with a mean age of 55 (±11.8), participated as a control group. The experimental/treatment group received traditional therapy with the CIMT where the intact contralateral upper limb was placed in a removable cast for 6 hours a day during waking hours for 4 weeks. The control group received traditional therapy only. Both groups were assessed using the BI on admission and on discharge from rehabilitation. In addition, 18 participants (14 male and 4 female), 64% of the experimental group, were reevaluated using the BI for the long-term benefits of CIMT on dependency. Results: Using unpaired t test (SPSS version 15), statistically significant improvement was noted in the BI for the experimental group compared to the control group. After 6 months follow-up, BI was 96.3 ± 2.7, indicating that the obtained gains were maintained at 6 months post discharge, compared to their BI score at 4 weeks (68.2 ± 3.8) post CIMT (p value < .005). Conclusion: Following stroke, patients who received CIMT every day for 4 weeks in conjunction with traditional rehabilitation therapy showed significant changes in the BI upon discharge and this positive outcome was preserved after 6 months follow-up. This improvement indicates an overall significant improvement in ADL status for patients who received CIMT and has implications for future use in stroke rehabilitation as home-based therapy for stroke rehabilitation. © 2009 Thomas Land Publishers, Inc.