Online citations, reference lists, and bibliographies.

Effect Of Constraint-induced Movement Therapy On Upper Extremity Function 3 To 9 Months After Stroke: The EXCITE Randomized Clinical Trial.

S. Wolf, C. Winstein, J. P. Miller, E. Taub, G. Uswatte, D. Morris, Carol Giuliani, Kathye E. Light, D. Nichols-Larsen
Published 2006 · Medicine

Cite This
Download PDF
Analyze on Scholarcy
Share
CONTEXT Single-site studies suggest that a 2-week program of constraint-induced movement therapy (CIMT) for patients more than 1 year after stroke who maintain some hand and wrist movement can improve upper extremity function that persists for at least 1 year. OBJECTIVE To compare the effects of a 2-week multisite program of CIMT vs usual and customary care on improvement in upper extremity function among patients who had a first stroke within the previous 3 to 9 months. DESIGN AND SETTING The Extremity Constraint Induced Therapy Evaluation (EXCITE) trial, a prospective, single-blind, randomized, multisite clinical trial conducted at 7 US academic institutions between January 2001 and January 2003. PARTICIPANTS Two hundred twenty-two individuals with predominantly ischemic stroke. INTERVENTIONS Participants were assigned to receive either CIMT (n = 106; wearing a restraining mitt on the less-affected hand while engaging in repetitive task practice and behavioral shaping with the hemiplegic hand) or usual and customary care (n = 116; ranging from no treatment after concluding formal rehabilitation to pharmacologic or physiotherapeutic interventions); patients were stratified by sex, prestroke dominant side, side of stroke, and level of paretic arm function. MAIN OUTCOME MEASURES The Wolf Motor Function Test (WMFT), a measure of laboratory time and strength-based ability and quality of movement (functional ability), and the Motor Activity Log (MAL), a measure of how well and how often 30 common daily activities are performed. RESULTS From baseline to 12 months, the CIMT group showed greater improvements than the control group in both the WMFT Performance Time (decrease in mean time from 19.3 seconds to 9.3 seconds [52% reduction] vs from 24.0 seconds to 17.7 seconds [26% reduction]; between-group difference, 34% [95% confidence interval {CI}, 12%-51%]; P<.001) and in the MAL Amount of Use (on a 0-5 scale, increase from 1.21 to 2.13 vs from 1.15 to 1.65; between-group difference, 0.43 [95% CI, 0.05-0.80]; P<.001) and MAL Quality of Movement (on a 0-5 scale, increase from 1.26 to 2.23 vs 1.18 to 1.66; between-group difference, 0.48 [95% CI, 0.13-0.84]; P<.001). The CIMT group achieved a decrease of 19.5 in self-perceived hand function difficulty (Stroke Impact Scale hand domain) vs a decrease of 10.1 for the control group (between-group difference, 9.42 [95% CI, 0.27-18.57]; P=.05). CONCLUSION Among patients who had a stroke within the previous 3 to 9 months, CIMT produced statistically significant and clinically relevant improvements in arm motor function that persisted for at least 1 year. Trial Registration clinicaltrials.gov Identifier: NCT00057018.
This paper references
10.1016/S0003-9993(99)90163-6
Constraint-induced movement therapy for motor recovery in chronic stroke patients.
A. Kunkel (1999)
10.1161/01.STR.30.10.2131
The stroke impact scale version 2.0. Evaluation of reliability, validity, and sensitivity to change.
P. Duncan (1999)
10.1177/0888439003259415
Treatment Interventions for the Paretic Upper Limb of Stroke Survivors: A Critical Review
S. Barreca (2003)
10.1016/0022-3956(75)90026-6
"Mini-mental state". A practical method for grading the cognitive state of patients for the clinician.
M. Folstein (1975)
10.1177/1545968304271370
The Effects of Constraint-Induced Therapy on Precision Grip: A Preliminary Study
J. Alberts (2004)
10.1161/01.STR.0000170706.13595.4f
Factors Influencing Stroke Survivors' Quality of Life During Subacute Recovery
D. Nichols-Larsen (2005)
American Heart Association home page
DS Nichols-Larsen
fectiveness of constraint - induced movement therapy in chronic stroke patients
SL Fritz (2004)
10.1161/01.STR.0000221281.69373.4e
Motor Cortex Activation During Treatment May Predict Therapeutic Gains in Paretic Hand Function After Stroke
Y. Dong (2006)
10.1097/01.NRL.0000031014.85777.76
Repetitive Task Practice: A Critical Review of Constraint-Induced Movement Therapy in Stroke
S. Wolf (2002)
10.1177/0888439003255511
Methods for a Multisite Randomized Trial to Investigate the Effect of Constraint-Induced Movement Therapy in Improving Upper Extremity Function among Adults Recovering from a Cerebrovascular Stroke
C. Winstein (2003)
10.1161/01.STR.30.3.586
Effects of constraint-induced movement therapy on patients with chronic motor deficits after stroke: a replication.
W. Miltner (1999)
Forced use of hemiplegic upper extremities to reverse the effect of learned nonuse among chronic stroke and headinjured patients Constraint-induced movement therapy
Sl Wolf (1989)
How to Use Shaping
M. Panyan (1980)
Designing practice for motor learning: clinical impressions
C. Winstein (1991)
10.1161/01.STR.0000143320.64953.C4
Constraint-induced movement therapy.
J. Grotta (2004)
Adult hemiplegia: Evaluation and treatment
Berta Bobath (1978)
Effectiveness of constraint-induced movement therapy in chronic stroke patients.
A. Suputtitada (2004)
10.1161/01.STR.0000083699.95351.F2
Randomized clinical trial of therapeutic exercise in subacute stroke.
P. Duncan (2003)
10.1177/0888439003259424
Home Forced Use in an Outpatient Rehabilitation Program for Adults with Hemiplegia: A Pilot Study
S. Pierce (2003)
10.1037/0090-5550.50.1.34
Implications of the learned nonuse formulation for measuring rehabilitation outcomes : Lessons from Constraint-Induced Movement Therapy
G. Uswatte (2005)
10.1901/jeab.1994.61-281
An operant approach to rehabilitation medicine: overcoming learned nonuse by shaping.
E. Taub (1994)
10.1212/01.wnl.0000238164.90657.c2
The Motor Activity Log-28
G. Uswatte (2006)
Motor Control and Learning: A Behavioral Emphasis
R. Schmidt (1982)
10.1161/01.STR.0000019289.15440.F2
Persisting Consequences of Stroke Measured by the Stroke Impact Scale
S. Lai (2002)
10.1007/s004150170207
Motor cortex plasticity during forced-use therapy in stroke patients: a preliminary study
J. Liepert (2001)
10.1097/01.phm.0000166881.71097.9d
Paretic Hand Rehabilitation with Constraint-Induced Movement Therapy After Stroke
I. Tarkka (2005)
10.1016/S0014-4886(89)80005-6
Forced use of hemiplegic upper extremities to reverse the effect of learned nonuse among chronic stroke and head-injured patients
S. Wolf (1989)
10.1161/01.STR.0000166043.27545.e8
AutoCITE: Automated Delivery of CI Therapy With Reduced Effort by Therapists
E. Taub (2005)
10.4135/9781412963862.n18
American Heart Association.
M. Cowan (1988)
The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance.
A. Fugl-Meyer (1975)
10.1310/BLJX-M89N-PTPY-JDKW
Constraint-Induced Therapy Approach to Restoring Function After Neurological Injury
D. Morris (2001)
in humans
WH Miltner (2000)
10.1037/0090-5550.43.2.152
Constraint-induced movement therapy: A new approach to treatment in physical rehabilitation.
E. Taub (1998)
on February
10.1093/ptj/63.9.1393
Electromyographic biofeedback applications to the hemiplegic patient. Changes in lower extremity neuromuscular and functional status.
S. Wolf (1983)
10.1038/nrn754
New treatments in neurorehabiliation founded on basic research
E. Taub (2002)
10.1161/01.STR.0000165922.96430.d0
Active Finger Extension Predicts Outcomes After Constraint-Induced Movement Therapy for Individuals With Hemiparesis After Stroke
S. Fritz (2005)
10.1161/01.STR.0000185928.90848.2e
Reliability and Validity of the Upper-Extremity Motor Activity Log-14 for Measuring Real-World Arm Use
G. Uswatte (2005)
10.4324/9780429266003-2
Survivors
Gwyn McClelland (1891)
10.1016/J.APMR.2004.05.007
Distributed form of constraint-induced movement therapy improves functional outcome and quality of life after stroke.
C. Dettmers (2005)
10.1161/01.STR.0000174192.87887.70
Daily Functioning and Quality of Life in a Randomized Controlled Trial of Therapeutic Exercise for Subacute Stroke Survivors
S. Studenski (2005)
Somatosensory deafferentation research with monkeys: implications for rehabilitation medicine
E. Taub (1980)
10.1016/s0003-9993(03)00481-7
Efficacy of modified constraint-induced movement therapy in chronic stroke: a single-blinded randomized controlled trial.
S. Page (2004)
Manage - ment of adult stroke rehabilitation care : a clinical practice guideline
PW Duncan (2003)
10.1161/01.STR.0000180861.54180.FF
Management of Adult Stroke Rehabilitation Care: a clinical practice guideline.
P. Duncan (2005)
Electromyographic biofeedback applications to the hemiplegic patient. Changes in upper extremity neuromuscular and functional status.
S. Wolf (1983)
Technique to improve chronic motor deficit after stroke.
E. Taub (1993)
10.1053/APMR.2001.23183
The reliability of the wolf motor function test for assessing upper extremity function after stroke.
D. Morris (2001)
10.1177/001088046600700305
The
H. Peretz (1966)
10.1016/S0003-9993(99)90339-8
Constraint-induced movement therapy.
J. H. van der Lee (2000)
10.1161/01.STR.31.6.1210
Treatment-induced cortical reorganization after stroke in humans.
J. Liepert (2000)
10.1161/01.STR.32.7.1635
Assessing Wolf Motor Function Test as Outcome Measure for Research in Patients After Stroke
S. Wolf (2001)
10.1161/01.STR.0000087172.16305.CD
Probability of regaining dexterity in the flaccid upper limb: impact of severity of paresis and time since onset in acute stroke.
G. Kwakkel (2003)



This paper is referenced by
10.3233/978-1-60750-018-6-3
Rehabilitation as empowerment: the role of advanced technologies.
G. Riva (2009)
10.1097/NPT.0000000000000096
Rasch Analysis of the Wrist and Hand Fugl-Meyer: Dimensionality and Item-Level Characteristics
Andrew C. Persch (2015)
A randomized comparison of effectiveness of modified constraint induced movement therapy versus conventional physiotherapy on upper-extremity dysfunction in the treatment of adult hemiplegia
S. Gupta (2018)
10.2147/CIA.S179691
Using the Borg rating of perceived exertion scale to grade the intensity of a functional training program of the affected upper limb after a stroke: a feasibility study
M. Milot (2019)
10.1177/1545968316662527
Upper Limb Obstacle Avoidance Behavior in Individuals With Stroke
M. C. Baniña (2017)
BilateralActivity-DependentInteractionsintheDeveloping CorticospinalSystem
KathleenM . Friel (2007)
10.1016/j.pmrj.2011.05.007
Cognitive impairment in acquired brain injury: a predictor of rehabilitation outcomes and an opportunity for novel interventions.
E. Whyte (2011)
10.1310/tsr1903-193
Meaningful Task-Specific Training (MTST) for Stroke Rehabilitation: A Randomized Controlled Trial
Kamal Narayan Arya (2012)
10.1007/s00115-012-3566-x
Transkranielle Hirnstimulation nach Schlaganfall
Friedhelm Christoph Hummel (2012)
10.1016/j.neuron.2013.10.028
Activity-Dependent Neural Plasticity from Bench to Bedside
K. Ganguly (2013)
10.3389/fnhum.2014.00451
Enhanced motor skill acquisition in the non-dominant upper extremity using intermittent theta burst stimulation and transcranial direct current stimulation
Raymond Butts (2014)
10.1177/1545968314547766
Comparison of Three Tools to Measure Improvements in Upper-Limb Function With Poststroke Therapy
Angelica G. Thompson-Butel (2015)
10.1097/WCO.0000000000000024
Motor rehabilitation in stroke and traumatic brain injury: stimulating and intense.
Erika Y Breceda (2013)
10.1007/978-3-642-54707-2_8
Improving the Efficacy of Ipsilesional Brain-Computer Interface Training in Neurorehabilitation of Chronic Stroke
Surjo R. Soekadar (2014)
with cerebral palsy: a randomized controlled trial Adapted version of constraint-induced movement therapy promotes functioning in children
T Fonseca (2014)
10.1017/9781316148525
Knowing Hands: The Cognitive Psychology of Manual Control
David A. Rosenbaum (2017)
10.1016/B978-0-12-805298-3.00015-3
Constraint-Induced Movement Therapy: When Efficacious Motor Therapy Meets Progressive Disease
Ameen Barghi (2017)
10.1590/1809-2950/16874424022017
Influência da terapia de restrição e indução do movimento no desempenho funcional de pacientes com acidente vascular encefálico: um ensaio clínico randomizado
Edson Meneses da Silva Filho (2017)
10.3138/ptc.2012-51
Constraint-induced movement therapy to improve paretic upper-extremity motor skills and function of a patient in the subacute stage of stroke.
Saleh M. Aloraini (2014)
Tasks in People With Hemiparesis After Stroke Three-Dimensional Kinematic Analysis of Reaching Reproducibility and Minimal Detectable Change of
Joanne M. Wagner (2008)
10.1177/1545968309349941
Does Provision of Extrinsic Feedback Result in Improved Motor Learning in the Upper Limb Poststroke? A Systematic Review of the Evidence
Sandeep K Subramanian (2010)
10.15453/2168-6408.1514
The Feasibility of Conducting Task-Oriented Training at Home for Patients with Stroke
Veronica T. Rowe (2019)
Modified constraint-induced movement therapy in children with congenital hemiplegic cerebral palsy
Pavlina Psychouli (2008)
10.1177/0269215507084581
Short- and long-term outcome of constraint-induced movement therapy after stroke: a randomized controlled feasibility trial
A. Dahl (2008)
Effects of lower extremity power training on gait biomechanics in old adults : The Potsdam Gait Study (POGS)
Chantal M. I. Beijersbergen (2017)
10.1007/s13295-015-0015-x
Learning from brain control: clinical application of brain–computer interfaces
Niels Birbaumer (2015)
10.1080/09593985.2018.1493759
Effects of in home high dose accelerometer-based feedback on perceived and actual use in participants chronic post-stroke
M. Whitford (2018)
10.1177/0269215507078333
Six hours in the laboratory: a quantification of practice time during constraint-induced therapy (CIT)
Richard T Kaplon (2007)
10.3233/NRE-2008-23103
Constraint-induced movement therapy in stroke rehabilitation: perspectives on future clinical applications.
S. Blanton (2008)
10.1016/B978-1-4160-4721-6.50007-9
Chapter 5 – Treatment
L. Caplan (2009)
10.1016/B978-008045046-9.01319-X
Map Plasticity and Recovery from Stroke
Randolph J. Nudo (2009)
10.1016/S1474-4422(09)70061-4
Neurorestorative therapies for stroke: underlying mechanisms and translation to the clinic
Z. Zhang (2009)
See more
Semantic Scholar Logo Some data provided by SemanticScholar