• The Journal of Korean Physical Therapy
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• v.23 no.5
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• pp.65-72
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• 2011

Purpose: The intention of this study was to investigate the effects of modified constraint-induced movement therapy (mCIMT) with bilateral arm training (BAT) on the motor performance and daily activity performance of individuals with chronic hemiparetic stroke. Methods: Sixteen subjects one year after stroke participated in this study with a control group; the pretest-posttest method was used. The subjects were randomly allocated into two groups: combination of bilateral arm training and modified constraint-induced movement therapy (n=8), and modified constraint-induced movement therapy (n=8). The mCIMT group received therapy for 90 minutes in 3 sessions per week over a period of 4 weeks. The patients receiving a combination of mCIMT and BAT were treated for the same period and frequency. The results were evaluated using the Fugl-Meyer Assessment, Action Research Arm Test (ARAT), and Motor Activity Log-Amount of Use, and Quality of Movement (MAL-AOU, QOM) assessment tools. Results: The Fugl-Meyer Assessment showed that hand and wrist performance improved significantly more in the mCIMT group than in the Combination group (p<0.05). Result from the ARAT assessment showed greater scores for gross movement in the combined group than in the mCIMT group (p<0.05). The MAL-AOU showed that there was greater improvement in the combined group than in the mCIMT group (p<0.05). Conclusion: The forced use of the more affected side can be important for the enhancement of upper extremity performance for chronic hemiparetic stroke patients during their daily activities.

• The Journal of the Korea Contents Association
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• v.8 no.9
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• pp.194-203
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• 2008

CIMT(Constraint Induced Movement Therapy) is to improve the function and use of damaged upper limbs by not only confinement of unaffected limbs' exercise but also inducement of affected limbs' one. The purpose of the study is to verify the effect of CIMT by means of motor behaviour test and immunohistochemistry, using animal models. This study was analyzed using 40 male Sprague-Dawley rats as the experimental groups and 40 ones as the control groups. The rats were divided into two random groups : one group as an experimental group which was operated on under anesthesia and removed somatomotor regions with CIMT and the other as the control group without CIMT.Postural Reflex Test, Beam Walking Test, Limb Placement Test and Immunohistochemistry were run on the day 1, 3 , 7 and day 14 following surgery to each 10 rat. As a result, this study demonstrates that CIMT might be an effect method to verify the plasticity of central nervous system as motor behaviour test made all high scores (p<.05) and BDNF was high too in experimental groups.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.3
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• pp.25-36
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• 2021

Background: This study aimed to investigate the effect of modified constraint-induced movement therapy (mCIMT) and resistive exercise using elastic band with pressure belt on improving upper extremity function in stroke patients. Methods: Sixteen patients with stroke were randomly assigned to a control group that received mCIMT and resistive exercise using elastic band (n=8) and an experimental group that received mCIMT and resistive exercise using elastic band with pressure belt (n=8). Over the course of four weeks, mCIMT were conducted 60 minute three times per week and resistive exercise using elastic band (with pressure belt) were conducted twice daily, three times per week. The function of the upper extremities were evaluated before, after 2 weeks and 4 weeks using the grip strength test (GST), the box and block test (BBT), and motor activity log (MAL). Results: The values for the GST, the BBT, and MAL increased in both groups as the treatment period progressed. The values for the GST (p<.01), the BBT (p<.001), and MAL (p<.001) were significantly higher in the experimental group than in the control group at 4 weeks after initiating the treatment. Conclusion: We found that mCIMT and wearing a pressure belt during resistive exercise was very useful in improving the function of the upper extremities in patients with stroke.

• Journal of health informatics and statistics
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• v.41 no.1
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• pp.49-56
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• 2016

Objectives: Carotid intima-media thickness (CIMT) and the presence of carotid artery plaque are widely used as preclinical markers of atherosclerosis. Due to operator dependency in measuring CIMT, it is important to evaluate the reliability of measuring CIMT and plaque between centers in a multicenter study. The purpose of this study is to evaluate the inter-rater reliability of CIMT and plaque presence among three clinical centers of the Cardiovascular and Metabolic Disease Etiology Research Center (CMERC). Methods: Twenty people without known cardiovascular disease (age 37-64) were enrolled during 2014-2015, and their left and right carotid arteries were examined repeatedly with ultrasonography for CIMT measurements at three clinical centers according to a predetermined protocol. Maximum and mean values of CIMT at distal common carotid artery were recorded. Plaque presence at a carotid artery was checked by an operator. The reliability of CIMT and carotid plaque presence was assessed using an intraclass correlation coefficient (ICC) and kappa statistics, respectively. Results: Calculated ICC was 0.647 (95% CI: 0.487-0.779) for maximum CIMT, and 0.758 (95% CI: 0.632- 0.854) for mean CIMT. In Bland Altman plot, most observed values were distributed within mean difference ${\pm}1.96$ SD ranges. Kappa statistics of plaque presence between two centers were 0.304 (center 1 and 2), 0.507 (center 1 and 3), and 0.606 (center 2 and 3), respectively, while Fleiss kappa for overall agreement was 0.445. Conclusions: The inter-rater reliability of CIMT measurements among three clinical centers turned out to be high, and the agreement of measuring carotid plaque presence was fair.

• The Journal of Korean Physical Therapy
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• v.17 no.4
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• pp.493-504
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• 2005

The purpose of this study is to determine the effect of constraint-induced movement therapy on the involved hand function and ADL in stroke patients. Five subjects with fixing unaffected arms by CIMT were assigned to the experimental patient group and the other five patients to control group without fixing unaffected arms. The function of hand for both groups were evaluated by using Jebsen-Taylor hand function test and ADL for both groups were evaluated by FIM(Functional Independence Measure) before and after task practice. In conclusion, results of this study showed that improved hand function and ADL by CIMT in stroke patients. We concluded that CIMT can improved the involved hand function and ADL in stroke patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.7
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• pp.3023-3029
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• 2012

The purpose of this study was to investigate the effect of the home-based virtual reality (VR) on upper extremity motor function in hemiparetic stroke patients. Two matched subjects with left hemiplegia were volunteered to participate in this study. One subject received the home-based VR whereas the other subject recovered a modified home-based constraint-induced movement therapy (CIMT). Both interventions were given for 4 hours x 5 times a week for 4 weeks. Outcome measures included Fugl-Meyer Assessment (FMA), Motor Activity Log (MAL), and Wolf Motor Function Test (WMFT). The VR-trained subject showed considerable improvement in all the tested motor functions when compared with the home-based CIMT. Specifically, the FMA measure demonstrated that the VR subject showed 17% enhancement whereas the CIMT subject showed 5% increase. Similarly, Amount of Use (AOU) and Quality of Movement (QOM) of the MAL scores of the VR subject showed 40% and 20% increase whereas the CIMT subject showed 0% and 20% increase, respectively. The WMFT scores of the VR subject and CIMT subject showed 20% increase. Our home-based VR was effective in upper extremity motor recovery of chronic hemiparetic patients even when compared with the well-established CIMT approach in stroke victims.

• Therapeutic Science for Rehabilitation
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• v.2 no.2
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• pp.5-20
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• 2013

Constraint Induced Movement Therapy(CIMT) is intense in that patient's unaffected arm is restrained for 90% of waking hours during a two-week period while they also participate in activity sessions using the affected arm for 6 hours/day. However CIMT showed that an issue for applying it to clinics of patients with stroke, and then modified constraint induced movement therapy(mCIMT) was designed to minimize the issue. Application on mCIMT for the patients has been studied in various ways. As a result, it has proved the effect on functional improvement of patients with stroke through methods such as MAL, FMA, WMFT, ARAT, FIM, SIS and so forth. It's considered that modified constraint induced movement therapy can be useful applied on clinical experiments of occupational therapy, as it is a way of treatment of upper extremity function, activities of daily living and an improvement of the quality of life for stroke patients.

• Physical Therapy Korea
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• v.14 no.3
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• pp.48-56
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• 2007

Environmental Enrichment (EE) alone is not capable of enhancing the fine digit and the forelimb functions. Therefore, we applied modified constraint-induced movement therapy (mCIMT) under the influence of EE to assess its effect on promoting improved forelimb sensorimotor functions. Focal ischemic brain injury was produced in Sprague-Dawley rats (60 rats, $250{\pm}50$ g) through middle cerebral artery occlusion (MCAO). Before MCAO induction, all rats were trained in modified limb placing tests and reaching tasks for 1 week. Then they were randomly divided into three groups: Group I: application of standard environment (SE) after MCAO induction (n=20), Group II: application of EE after MCAO induction (n=20), Group III: MCAO+EE, mCIMT and task-oriented training that was initiated at 10th day after MCAO induction (n=20). We also applied mCIMT (between 9 AM and 5 PM/daily) which included restraining the forelimb ipsilateral to the lesion using the 'Jones & Schallert' method. We assessed the change of modified limb placing, single pellet reaching test and the immunoreactivity of BDNF by immunohistochemistry (pre, 1st, 5th, 10th and 20th day). Group I showed no improved outcome, whereas group II and III significantly improved on the use of the forelimb and the immunoreactivity. The qualitative analysis of the skilled reaching test, of group III showed the greatest improvement in the fine digit and the forelimb function. These results suggest that EE combined with mCIMT is more functional in promoting enhanced fine digit and forelimb functional movements.

• The Journal of Korean society of community based occupational therapy
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• v.7 no.1
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• pp.25-35
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• 2017

Objective : The aims of this study was to investigate the effects of modified constraint induced movement therapy(CIMT) on upper extremities function of children with hemiplegic cerebral palsy. Methods : The participants of this study are 4 children with hemiplegic cerebral palsy aged between 8 to 11 years old. During the modified CIMT period, the unaffected hand of the subjects was restrained by a hand splint for 8 weeks, five days per week, five hours a day. And the affected upper extremity was strongly trained by performing functional tasks, which were individually structured use of the affected arm. Measurements used to assess hand function are Jebsen Hand Function Test, and 3D Motion Analysis. The Jebsen Hand Function Test was performed repeatedly every two weeks. The 3D Motion Analysis was performed before and after the 8 weeks of modified constraint induced movement therapy. Results : After the modified CIMT, there was a significant improvement in completed time for the 6 tasks of Jebsen Hand Function Test(p<.05). 3D Motion Analysis was that the finger tapping and the hand tapping has been significantly decreased (p<.05), and the pronation-supination movement has been significantly increased as well(p<.05). Conclusion : In the results of this study, it is evidenced that modified CIMT is effective treatment for upper extremities function of children with hemiplegic cerebral palsy. For future research, it is recommended to examine various periods and protocol of modified CIMT including impact of long periods application.

• The Journal of Korean society of community based occupational therapy
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• v.9 no.2
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• pp.33-42
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• 2019

Objective : The aim of this study was to evaluate the current knowledge regarding constraint-induced movement therapy (CIMT) and its application in clinical practice by physiatrists and therapists in pediatric rehabilitation area in Korea. Methods : Online survey via E-mails was sent to a total of 510 members (204 physiatrists and 306 therapists) of the Korean Society of Pediatric Rehabilitation and Developmental Medicine (KSPRDM). Results : The response rate was 35.1% (179 of 510). A total of 179 questionnaires was completed by 39 physiatrists, 89 physiotherapists, 48 occupational therapists, and 3 speech therapists. 45.8% of responders had worked over 6 years in the pediatric rehabilitation setting and a total of 58.1% (n=104) of the sample had used CIMT. The main limitations of clinically applying CIMT included limited staff and inappropriate clinical setting (35.1%, n=61), lack of understanding (19.5%, n=34), and developmental issues of function on the unaffected side (13.8%, n=24). The cooperation of patients (77.6%, n=76), cognitive/behavioral factors (42.9%, n=42), and cooperation of caregivers (25.5%, n=25) were the 3 major concerns that could be limitations with CIMT. Conclusions : Although considerable evidence supports the use of CIMT, many of physiatrist and therapists do not apply this method in practice. The improvement of limitations is necessary for wide use of CIMT in clinical practice in Korea.