EFFICACY OF MODIFIED CONSTRAINT INDUCED MOVEMENT THERAPY FOR LOWER EXTREMITY IN PATIENTS WITH STROKE: STRENGTH AND QUALITY OF LIFE OUTCOMES

EFFICACY OF MODIFIED CONSTRAINT-INDUCED MOVEMENT THERAPY FOR LOWER EXTREMITY IN PATIENTS WITH STROKE: STRENGTH AND QUALITY OF LIFE OUTCOMES

Abstract

Purpose: The purpose of this study was to examine the efficacy of modified constraint-induced movement therapy (mCIMT), which was applied to lower extremity, on strength and quality of life in patients with stroke. Methods: 30 patients with stroke were randomized to 2 groups. Both groups received first neurodevelopmental therapy (NDT) for 4 weeks as baseline treatment following which the study group received mCIMT and the control group received NDT for 2 weeks as experimental treatment. All were evaluated 3 times (pre-baseline treatment, post-baseline treatment, post-experimental treatment) through Motricity Index (MI), Stroke Impact Scale (SIS) and Stroke Specific Quality of Life (SS-QoL) scale. Results: The total score, mobility, self-care, upper extremity function, thinking, mood, family and social roles subdomain scores of the SS-QoL significantly increased in the study group, particularly during the experimental treatment period (p < 0.05). The amount of perceived recovery domain of SIS was greater in the study group during both the experimental and total treatment periods (p = 0.000). Significant improvement was observed in paretic lower extremity strength only in the study group for the total treatment period (p = 0.029). Correlations between the total change of scores in strength and quality of life and the changes in the experimental treatment period were found strong. Conclusion: This study shows that mCIMT is more effective than NDT in patients with stroke to improve paretic lower extremity strength and health related quality of life.

Özet

Purpose: This study was aimed to examine the efficacy of modified constraint-induced movement therapy (mCIMT), which was applied to lower extremity, on strength and quality of life (QoL) in patients with stroke.Methods: Thirty patients with stroke were randomly divided into two groups. Both groups received neuro-developmental therapy (NDT) for four weeks as baseline treatment. After four weeks, when the study group received mCIMT, the control group continued NDT for two weeks as the experimental treatment. The strength was evaluated using Motricity Index, and QoL was evaluated using Stroke Specific Quality of Life Scale (SS-QoL), and Stroke Impact Scale (SIS) for three times (baseline, post 4 weeks, and post 6 weeks). Results: The strength and QoL improved in both groups for all treatment periods (p<0.01). The paretic lower limb strength developed more in the mCIMT group for the total treatment period (p=0.029). The total score of the SS-QoL and mobility, self-care, thinking, mood, family, and social roles subdomain scores of the SS-QoL were more pronounced in the mCIMT group after the mCIMT period (p<0.05). The amount of perceived recovery domain of SIS was greater in the mCIMT group after mCIMT and total treatment periods according to the control group (p<0.001). The total changes in strength and QOL were strongly correlated with the improvement in the mCIMT period (r=0.709, p<0.01 and r=0.769, p<0.01) than in the baseline period (r=0.660, p<0.01 and r=0.505, p<0.01). Conclusion: The study showed that mCIMT could be used as an effective treatment method for patients with stroke to improve paretic lower extremity strength and health-related QoL.