Self-regulated Constraint-induced Movement Therapy in Subacute Stroke Patients
Stroke
About this trial
This is an interventional treatment trial for Stroke focused on measuring Self-regulation, Constraint-induced movement therapy, Stroke, Functional recovery, Randomized controlled trial
Eligibility Criteria
Inclusion Criteria:
- sustained an ischemic type stroke with lesion in the primary or motor cortical areas resulting in hemiplegia,
- had stroke onset of less than 3 months,
- were aged above 60, and
- had 10 degree active extension in metacarpophalangeal joint and interphalangeal joint, 20 degree active extension of wrist joint
Exclusion Criteria:
- had excessive spasticity in the affected limb, as defined by a score of 2 or more on the Modified Ashworth Scale,
- had excessive pain in the affected limb, as defined by a score 4 or more using a Visual Analog Scale,
- had a score below 19 on the Mini-Mental Status Examination (MMSE), and
- had diagnosed of depression according to Diagnostic and Statistical Manual-IV (DSM-IV) criteria
Sites / Locations
- Shatin Hospital
- Pok Oi Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Active Comparator
Active Comparator
Self-regulated constraint-induced movement therapy
Constraint-induced movement therapy
Conventional occupational therapy
Self-regulated constraint-induced movement therapy (SR-CIMT) - participants' non-hemiplegic arm was restrained in a mitt for 4 hours every day, 2 weeks, 5 days a week (therapy days) (CIMT) (the same CIMT protocol as in the CIMT group described under 'comparator/control treatment'); participants were taught using the self-regulation (SR) strategy to relearn the tasks; SR strategy involved participants self reflecting on their abilities and deficits in performing the tasks, identifying problems and solutions in achieving the most independence in the tasks, and then actually carrying out the tasks.
In the constraint-induced movement therapy group (CIMT), participants' non-hemiplegic arm was restrained in a mitt for 4 hours every day, 2 weeks, 5 days a week (therapy days); therapist provided demonstration on the adapted task performance with one arm (the side of participants' hemiplegic arm), and participants to practice the tasks with the unrestrained hemiplegic arm under supervision.
It involved therapist to demonstrate the adapted task performance followed by patient's practice under supervision.