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. 2022 Dec 5:16:987061.
doi: 10.3389/fnhum.2022.987061. eCollection 2022.

Effects of constraint-induced movement therapy on activity and participation after a stroke: Systematic review and meta-analysis

Joyce Araújo de Azevedo  1 , Felipe Douglas Silva Barbosa  2 , Valquiria Martins Seixas  1 , Kelly Regina Dias da Silva Scipioni  3 , Priscila Yukari Sewo Sampaio  4 , Daniel Marinho Cezar da Cruz  5 , Daniele Piscitelli  6   7   8 , Kevin K Chui  9 , Aristela de Freitas Zanona  1
Affiliations

Effects of constraint-induced movement therapy on activity and participation after a stroke: Systematic review and meta-analysis

Joyce Araújo de Azevedo et al. Front Hum Neurosci. .

Abstract

Introduction: Hemiparesis is the main sensorimotor deficit after stroke. It can result in limitations in Activities of Daily Living (ADL) and social participation. Hemiparesis can be treated with behavioral techniques of intensive use of the affected arm, such as constraint-induced movement therapy (CIMT), however, it remains unclear whether motor improvement can lead to increases in the domains of activity and participation.

Objective: Identify whether CIMT is superior to usual techniques to enhance activity and participation outcomes in stroke survivors.

Methods: A systematic review with meta-analysis was conducted, based on the PRISMA guidelines. Search databases were: PubMed, LILACS, Embase, SciELO, Cochrane Library, Scopus, Medline, and Web of Science, with no language restriction. Meta-analysis was performed with Review Manager (version 5.3), significance level p ≤ 0.05.

Results: A total of 21 articles were included for analysis. Superior effects were observed on motor function and performance in activities of daily living of individuals treated with CIMT. The outcomes measures utilized were: Fugl-Meyer Assessment (p = 0.00001); Wolf motor function test (p = 0.01); Modified Barthel Index (p = 0.00001); Motor Activity log (MAL) Amount of use (AOU) (p = 0.01); MAL Quality of movement (QOM) (p = 0.00001); Action Research Arm Test-ARAT (p = 0.00001); and FIM (p = 0.0007).

Conclusion: Our results show that CIMT results in more significant gains in the functional use of the upper limb in ADL and functional independence, demonstrating superior activity and participation results in stroke survivors when compared to conventional therapies.

Keywords: activities of daily living; constraint-induced movement therapy; occupational therapy; social participation; stroke.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram.
FIGURE 2
FIGURE 2
Forest Plot of the manual function assessed by the Fugl Meyer test. SD, standard deviation; CI, confidence interval.
FIGURE 3
FIGURE 3
Forest Plot of the manual function assessed by the Wolf Motor Function test. SD, standard deviation; CI, confidence interval.
FIGURE 4
FIGURE 4
Forest Plot of the manual function assessed by the Action Research Arm Test. SD, standard deviation; CI, confidence interval.
FIGURE 5
FIGURE 5
Forest Plot of the activity/participation assessed by the test Modified Barthel Index. SD, standard deviation; CI, confidence interval.
FIGURE 6
FIGURE 6
(A) Forest Plot of the activity/participation assessed by the test Motor Activity Log Amount of Use. (B) Forest Plot of the activity/participation assessed by the test Motor Activity Log Quality of Movement. SD, standard deviation; CI, confidence interval.
FIGURE 7
FIGURE 7
Forest Plot of the activity/participation assessed by the test Function Independence Measure. SD, standard deviation; CI, confidence interval.
See this image and copyright information in PMC

References

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