Article

Constraint-induced movement therapy (CIMT) is used to counteract
learned nonuse observed following stroke in humans and has been shown to improve
function. Variations of CIMT used in animal models of stroke have the potential
to inform and improve our understanding of this intervention. OBJECTIVE: To
conduct a systematic review of studies investigating constraint in experimental
stroke. The authors aimed to assess the quality and establish the efficacy of
constraint on neurobehavior, cognitive function, infarct size, and stress and
mortality and to determine the optimal dose or time to administration. METHODS:
Systematic review with meta-analysis was used. Data were analyzed using
DerSimonian and Laird weighted-mean-difference random effects meta-analysis.
RESULTS: The quality scores of the 8 articles (15 studies) included were moderate
(median 5/10; interquartile range, 4.8-6.0). There was a trend for animals with
constraint to have worse neurobehavioral scores (-10% worse; 95% confidence
interval [CI] = -20 to 0; P = .06). Infarct volumes were not significantly
different between groups (-3% larger with constraint; 95% CI = -15 to 9; P =
.63). Cognitive function was significantly better after constraint, although this
estimate was based on only 28 animals from 2 studies. Insufficient data prevented
analysis of the effect of constraint on stress and mortality. CONCLUSIONS: This
meta-analysis showed no benefit of constraint on neurobehavioral scores, which is
at odds with some human studies. Animal models may help us efficiently explore
the biological basis of rehabilitation interventions; however, review of the data
in this study raise uncertainty about its effectiveness in humans.

Langue : ANGLAIS