Effects of modified constraint-induced movement therapy on the lower extremities in patients with stroke: a pilot study

Abstract

Purpose: This study aimed to qualify the improvements of modified constraint-induced movement therapy (m-CIMT) on the lower limb of stroke patients via assessing the centre of mass (COM) displacement and the basic gait parameters.

Methods: A total of 22 hemiplegic patients after stroke with first-time clinical cerebral infarction or haemorrhagic cerebrovascular accident were included in this study from May to December, 2014. The patients were randomly divided into m-CIMT group and the conventional therapy group (control group), and received corresponding training for five days/week for four weeks. The COM displacement and gait parameters were assessed by three-dimensional segmental kinematics method in pre-intervention and post- intervention therapy.

Results: After four weeks of m-CIMT, the COM displacement on sagittal plane of paretic leg during stance phase was increased (pre: 91.04 ± 4.39 cm, post: 92.38 ± 4.58 cm, p < 0.05) and swing range of frontal plane was remarkably decreased (pre: 10.15 ± 3.05 cm, post: 7.83 ± 1.90 cm, p < 0.001). Meantime, the normalised swing range of COM in m-CIMT was superior to that in control group. Moreover, the gait parameters, including velocity (0.27 m/s), step width (0.10 m), step length (0.22 m) and swing time percentage (29.80%), were significantly improved by post-interventions of m-CIMT (p < 0.05).

Conclusion: The m-CIMT intervention improves the COM displacement in sagittal and frontal plane, as well as gait parameters. These suggest that m-CIMT intervention may be feasible and effective for the rehabilitation of hemiplegic gait. Implications for Rehabilitation Segmental kinematics method was used to estimate the displacement of the COM. m-CIMT interventions improved the COM displacement of patients after stroke. m-CIMT interventions improved the hemiplegic gait parameters.

Keywords: Centre of mass; constraint-induced movement therapy; gait; stroke.