Improvement and impact of initial motor skill after intensive rehabilitation – CI-therapy in patients with chronic hemiplegia. A follow-up study

Previous studies suggest that constraint-induced movement therapy (CI-therapy) in the chronic phase after hemiplegia improves motor skill and increases the use of the affected arm. The purpose of the study was to evaluate outcome after modified CI-therapy and to study the influence of degree of motor skill. Twenty-six consecutive patients with chronic hemiplegia, who could actively extend the wrist 20° and the finger joints 10° were included. The patients were tested before and after a 2-week training period and 6 months later. Subgroup analyses were based on BL motor assessment, upper extremity. BL motor assessment, Finger–Nose Test (FNT), Motor Activity Log (MAL) and Patient-Specific Functional Scale (PSFS) were the main measures. Highly significant improvements (p<0.001) were found in all instruments (BL motor assessment, 6.5 points, FNT, 6 s, MAL, 1 step and PSFS, 3.3 steps). The result remained at the 6-month follow-up. Significant improvements were seen in all subgroups. The improvements did not differ between the subgroups. The literature states that no further improvements of motor arm function are to be expected in the chronic phase after stroke. This study showed that CI-therapy improved motor skill and use in daily life, and that the improvements remained after 6 months. The initial level of motor skill did not influence degree of improvement.