An Exploration of the Effectiveness of Different Intensity Protocols of Modified Constraint-Induced Therapy in Stroke: A Systematic Review.

IF 1.5 Q3 REHABILITATION Rehabilitation Research and Practice Pub Date : 2023-10-10 eCollection Date: 2023-01-01 DOI:10.1155/2023/6636987
Pavlina Psychouli, Ioannis Mamais, Charalambos Anastasiou
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Abstract

Purpose: To examine the effectiveness of different modified Constraint-Inuced Therapy (mCIMT) protocol intensities on upper extremity motor function in adults with hemiplegia.

Methods: A search was conducted in PubMed, Scopus, EBSCO, and Cochrane Library for articles published between April 2010 and December 2021. Only randomized controlled trials (RCTs) were included. Studies were excluded if they used a sample of less than five, mCIMT in combination with other therapy, and/or if they were not written in English. Methodologic quality was assessed using the Cochrane collaboration risk of bias tool-2.

Results: Thirty-six RCTs with a total of 721 participants were included. Most researchers followed a moderate to low protocol intensity in terms of total treatment time and moderate to high intensity with regard to restriction time. Almost all of the upper limb motor function measures showed statistically significant improvements (p < .05) after mCIMT, irrespective of the protocol's intensity, but there was lack of high-quality studies. Statistically significant improvements did not always translate to clinical importance.

Conclusions: Low-intensity CIMT protocols may result in comparable improvements to more intensive ones but caution has to be taken when drawing conclusions due to high risk of bias studies.

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探讨不同强度的改良约束诱导治疗方案在脑卒中中的有效性:一项系统综述。
目的:观察不同强度的改良约束性介入治疗(mCIMT)方案对成人偏瘫上肢运动功能的影响。方法:在PubMed、Scopus、EBSCO和Cochrane图书馆检索2010年4月至2021年12月期间发表的文章。仅纳入随机对照试验(RCT)。如果研究使用的样本少于五个,mCIMT与其他疗法相结合,和/或研究不是用英语写成的,则将其排除在外。使用Cochrane协作偏倚风险工具评估方法学质量。2结果:纳入36项随机对照试验,共721名参与者。大多数研究人员在总治疗时间方面遵循中等至低的方案强度,在限制时间方面遵循中度至高强度。无论方案的强度如何,mCIMT后几乎所有的上肢运动功能测量都显示出统计学上的显著改善(p<0.05),但缺乏高质量的研究。统计上显著的改善并不总是转化为临床重要性。结论:低强度CIMT方案可能会导致与高强度方案相当的改善,但由于偏倚研究的高风险,在得出结论时必须谨慎。
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来源期刊
CiteScore
3.80
自引率
0.00%
发文量
16
审稿时长
19 weeks
期刊介绍: Rehabilitation Research and Practice is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies in all areas of physical medicine and rehabilitation. The journal focuses on improving and restoring functional ability and quality of life to those with physical impairments or disabilities. In addition, articles looking at techniques to assess and study disabling conditions will be considered.
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