Number of repetitions versus duration in hours as dose measures of task practice during constraint induced movement therapy: a randomized controlled trial

Background. Constraint induced movement therapy (CIMT) is used in the rehabilita­tion of an upper limb after stroke. However, its protocol, especially the issue of a dose, seems not clear as duration in hours of task practice is used as a measure of dose.

Aim. The aim of this study is to compare the use of a number of repetitions (sCIMT) and duration in hours (tCIMT) of task practice as measures of dose during CIMT in chronic stroke patients.

Method. The sCIMT performed the same 8 functional tasks each of 20 times, 2 times a day, 5 times a week for 6 weeks with the affected limb (n=5). The unaffected limb was constrained in an arm sling for 90% of the waking hours during the period of the interven­tion. While tCIMT group performed 2 hours of tasks practice (8 tasks) convenient for them with the affected upper limb and constraint of the unaffected upper limb for 5 hours a day, 5 days a week for 6 weeks (n=5). The study data was collected using Wolf motor function test (WMFT) at baseline, 2, 4 and 6 weeks post-intervention. The data was analyzed using repeated measures ANOVA, independent t-test, and ANCOVA at p<0.05.

Findings. The results showed significant difference (p<0.05) in WMFT functional abil­ity between baseline, and 2, 4 and 6 weeks post-intervention in the sCIMT group. However, there were no significant differences (p>0.05) between sCIMT and tCIMT in WMFT func­tional ability and performance time at baseline, and 2, 4 and 6 weeks post-intervention.

Conclusion. sCIMT is effective and comparable to tCIMT. However, its protocol seems more clear, simple and practicable.