Article

OBJECTIVE: To evaluate in a preliminary manner the feasibility, safety, and
efficacy of Constraint-Induced Movement therapy (CIMT) of persons with impaired
lower extremity use from multiple sclerosis (MS). DESIGN: Clinical trial with
periodic follow-up for up to 4 years. SETTING:
University-based rehabilitation
research laboratory. PARTICIPANTS: A referred sample of ambulatory adults with
chronic MS (N=4) with at least moderate loss of lower extremity use (average item
score </=6.5/10 on the functional performance measure of the Lower Extremity
Motor Activity Log [LE-MAL]). INTERVENTIONS: CIMT was administered for 52.5 hours
over 3 consecutive weeks (15 consecutive weekdays) to each patient. MAIN OUTCOME
MEASURES: The primary outcome was the LE-MAL score at posttreatment. Secondary
outcomes were posttreatment scores on laboratory assessments of maximal lower
extremity movement ability. RESULTS: All the patients improved substantially at
posttreatment on the LE-MAL, with smaller improvements on the laboratory motor
measures. Scores on the LE-MAL continued to improve for 6 months afterward. By 1
year, patients remained on average at posttreatment levels. At 4 years, half of
the patients remained above pretreatment levels.
There were no adverse events,
and fatigue ratings were not significantly changed by the end of treatment.
CONCLUSIONS: This initial trial of lower extremity CIMT for MS indicates that the
treatment can be safely administered, is well tolerated, and produces
substantially improved real-world lower extremity use for as long as 4 years
afterward. Further trials are needed to determine the consistency of these
findings.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS