Article

PURPOSE: To examine eligibility for modalities such as constraint-induced
movement therapy (CIMT) and modified CIMT (mCIMT) in the subacute phase after
stroke and to define the share of patients who should be offered this treatment.
METHODS: A prospective, repeated-measures design was used. A total of 100
consecutive patients with arm paresis 1 to 2 weeks post stroke were screened.
Eligible for CIMT were patients who were cognitively intact, medically stable,
and able to extend the wrist and 3 fingers 10 degrees as a lower limit. The
active range of motion was registered, and motor function was assessed by the
Action Research Arm Test (ARAT) and the Nine Hole Peg Test at 1 to 2 weeks, 4
weeks, and 3 months post stroke. RESULTS: From 100 patients, 54 were excluded
from motor assessment, mostly due to cognitive impairments. Of the remaining 46
patients, 21 (46%) were eligible according to motor function of the hand at 1 to
2 weeks post stroke, whereas in the other patients motor function was either too
good or too poor. The share of patients eligible declined to 31% after 4 weeks
and 15% after 3 months. Within 3 months, 60% reached reasonable dexterity,
expressed by an ARAT score not greater-than 51, all receiving standard
rehabilitation. CONCLUSION: Results indicate that eligibility for CIMT or mCIMT
should not be considered before 4 weeks post stroke because much improvement in
arm function was shown to occur during the first month post stroke with standard
rehabilitation.

Langue : ANGLAIS