Nineteen years of constraint-induced movement therapy: A practice-based, retrospective, observational study.

Abstract

Background: Despite its proven efficacy and recommendations in national clinical guidelines, Constraint-Induced Movement Therapy (CIMT) is rarely implemented, sustained over time, nor evaluated in regular clinical practice.

Aims: To evaluate the effects of CIMT that has been delivered in a clinical setting over a sustained period of time, and to study the relationship between patient characteristics and outcomes.

Material and methods: This practice-based, retrospective, observational study utilised a before-and-after design. Eighty-seven patients with neurological disorders participated. Outcome measures, including the Patient-Specific Functional Scale (PSFS), Motor Activity Log, the Box and Block Test, BL Motor Assessment, active range of motion and modified Ashworth Scale, were recorded before treatment, after treatment, and six months post-intervention.

Results: Significant improvements with effect sizes r = 0.24-0.61 were observed across all variables at follow up, with 71% of patients demonstrating clinically relevant progress in activity performance (PSFS). Time since injury, rather than age, sex, diagnosis or initial function, influenced outcomes.

Conclusions: CIMT in a clinical setting is effective for a wide range of patients, and manageable to deliver over a sustained period of time.

Significance: Therapists engaged in neurological rehabilitation should consider this evidence-based method to enhance patients' activity performance in areas of importance.