Effects of Constraint-induced Movement Therapy on Spasticity in Patients with Hemiparesis after Stroke

• Published in: Journal of stroke and cerebrovascular diseases Vol. 22; no. 4; pp. 364 - 370
• Main Authors: Kagawa, Shinji, RPT, Koyama, Tetsuo, MD, PhD, Hosomi, Masashi, MD, PhD, Takebayashi, Takashi, OTR, Hanada, Keisuke, OTR, Hashimoto, Fumiaki, OTR, Domen, Kazuhisa, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-05-2013
• Subjects: Aged; Biomechanical Phenomena; Cardiovascular; Disability Evaluation; Electromyography; Exercise Therapy; Female; Humans; Male; Middle Aged; Motor Activity; Muscle; Muscle Spasticity - diagnosis; Muscle Spasticity - etiology; Muscle Spasticity - physiopathology; Muscle Spasticity - therapy; Neurology; paresis; Paresis - diagnosis; Paresis - etiology; Paresis - physiopathology; Paresis - therapy; Predictive Value of Tests; Recovery of Function; scale; Stroke - complications; Stroke - diagnosis; Stroke - physiopathology; Stroke - therapy; Time Factors; tone; training; Treatment Outcome; scale; Muscle; training; tone; paresis
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2011.09.021

Background We sought to examine the effects of constraint-induced movement therapy on spasticity in patients with hemiparesis after stroke in 10 patients with chronic hemiparesis in their upper extremities. Methods Patients underwent a modified version of constraint-induced movement therapy (5 hours daily for 10 weekdays over 2 consecutive weeks). Motor function was assessed by the Fugl-Meyer Assessment, Wolf Motor Function Test, and the Motor Activity Log. Spasticity was assessed by the modified Ashworth scale and electromyography (F frequency, mean F/M ratio). These assessments were obtained immediately before and after the 2-week intervention. Wilcoxon rank sum tests were performed on these data ( P < .05). Results Constraint-induced movement therapy significantly improved hand and arm function as indicated by the Fugl-Meyer Assessment, Wolf Motor Function Test, and the Motor Activity Log scores. Constraint-induced movement therapy also reduced spasticity as assessed by the modified Ashworth scale, F frequency, and mean F/M ratio. Conclusions Comparable to motor function, constraint-induced movement therapy effectively reduces spasticity as confirmed by electromyography.