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The effects of modified constraint-induced movement therapy combined with trunk restraint in subacute stroke: a double-blinded randomized controlled trial

Objective: To investigate the effects of a modified constraint-induced movement therapy (mCIMT) with trunk restraint in subacute stroke patients. Design: Double-blind, randomized controlled trial. Setting: Rehabilitation clinic. Participants: Eighteen subacute stroke patients with moderate motor impairment. Interventions: The patients were treated with either mCIMT combined with trunk restraint or mCIMT for 5 days per week for 4 weeks. The mCIMT combined with trunk restraint group participated in structured intervention sessions for use of the more affected upper-extremity in task-oriented activities with trunk restraint for 1 hour per day, and with the less affected upper-extremity restrained for 5 hours per day weeks. The mCIMT group followed the same protocol without trunk restraint. Main outcome measures: The outcome measures included the action research arm test (ARAT), the Fugl-Meyer assessment (FMA), the modified Barthel index (MBI), the motor activity log (MAL) and the maximal elbow extension angle during reaching (MEEAR) were completed at baseline and post intervention. Results: The mCIMT combined with trunk restraint group exhibited more improved in the ARAT, FMA, MBI, MAL and MEEAR compared with the mCIMT group. Statistical analyses showed significantly different in ARAT (P = 0.046), FMA (P = 0.008), MBI (P = 0.001), MAL-AOU (P = 0.024), MAL-QOM (P = 0.010) and MEEAR (P = 0.001) between groups. Conclusions: These results suggest that mCIMT combined with trunk restraint is more helpful to improve upper-extremity function than mCIMT only in subacute stroke patients with moderate motor impairment.