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Meta-Analysis
. 2022 Oct 6;19(19):12809.
doi: 10.3390/ijerph191912809.

Impact of Constraint-Induced Movement Therapy (CIMT) on Functional Ambulation in Stroke Patients-A Systematic Review and Meta-Analysis

Ravi Shankar Reddy  1 , Kumar Gular  1 , Snehil Dixit  1 , Praveen Kumar Kandakurti  2 , Jaya Shanker Tedla  1 , Ajay Prashad Gautam  1 , Devika Rani Sangadala  1
Affiliations
Meta-Analysis

Impact of Constraint-Induced Movement Therapy (CIMT) on Functional Ambulation in Stroke Patients-A Systematic Review and Meta-Analysis

Ravi Shankar Reddy et al. Int J Environ Res Public Health. .

Abstract

Constraint-induced movement therapy (CIMT) has been delivered in the stroke population to improve lower-extremity functions. However, its efficacy on prime components of functional ambulation, such as gait speed, balance, and cardiovascular outcomes, is ambiguous. The present review aims to delineate the effect of various lower-extremity CIMT (LECIMT) protocols on gait speed, balance, and cardiovascular outcomes. Material and methods: The databases used to collect relevant articles were EBSCO, PubMed, PEDro, Science Direct, Scopus, MEDLINE, CINAHL, and Web of Science. For this analysis, clinical trials involving stroke populations in different stages of recovery, >18 years old, and treated with LECIMT were considered. Only ten studies were included in this review, as they fulfilled the inclusion criteria. The effect of CIMT on gait speed and balance outcomes was accomplished using a random or fixed-effect model. CIMT, when compared to controlled interventions, showed superior or similar effects. The effect of LECIMT on gait speed and balance were non-significant, with mean differences (SMDs) of 0.13 and 4.94 and at 95% confidence intervals (Cis) of (-0.18-0.44) and (-2.48-12.37), respectively. In this meta-analysis, we observed that despite the fact that several trials claimed the efficacy of LECIMT in improving lower-extremity functions, gait speed and balance did not demonstrate a significant effect size favoring LECIMT. Therefore, CIMT treatment protocols should consider the patient's functional requirements, cardinal principles of CIMT, and cardiorespiratory parameters.

Keywords: balance; cardiovascular; functional ambulation; gait speed; lower-extremity CIMT; stroke.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart depicting the process of synthesis of included studies for this review.
Figure 2
Figure 2
Details of risk of bias among the included studies.
Figure 3
Figure 3
Gait speed: post-treatment and post-follow-up.
Figure 4
Figure 4
Balance: post-treatment and post-follow-up.
See this image and copyright information in PMC

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