• Physical Therapy Korea
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• v.19 no.2
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• pp.59-68
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• 2012

This meta-analysis investigated the effects on arm motor impairment, arm motor function and disability, and psychological aspects of constraint-induced movement therapy (CIMT) for upper extremity hemiparesis following stroke, based on Korean studies. A comprehensive search of the complete Korean studies information service system (KISS), Research Information Sharing Service (RISS), Korea National Library, and the Korean Medical Database to September 2011 was conducted. Eleven eligible controlled clinical trials compared CIMT to a control group or an alternative treatment. All outcome measures of arm motor impairment, arm motor function and disability, and psychological aspects were pooled for calculating effect size. The overall effect size of CIMT was .700 (95% confidence interval=.482~.918). The CIMT programs showed large effect on the aspect of arm motor function and disability (the effect size is .920) and the psychological aspect (the effect size is .946). The effect of CIMT on arm motor impairment was moderate (the effect size is .588). These results show that CIMT may improve upper extremity motor impairment, function and disability, and psychological aspects following stroke. However, these results were based on a small number of studies, and not all of them were randomized control trials. Additional research is needed to include larger well-designed trials to resolve these uncertainties.

• Therapeutic Science for Rehabilitation
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• v.8 no.4
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• pp.7-18
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• 2019

Objective : This systematic review aimed to investigate the impact of transcranial direct current stimulation combined with constraint-induced movement therapy (CIMT) in patients with stroke Methods : PubMed and NDSL databases were employed to review literature published between January 2009 and December 2018. The main search terms were "Transcranial direct current stimulation" or "tDCS," "Constraint-induced movement therapy" or "CIMT," "Upper extremity function," "Upper limb," and "Stroke." Based on the inclusion and exclusion criteria, 6 articles were selected. Furthermore, intervention effects on upper extremity function, activities of daily living, and cortical activity were assessed. Results : The current intensity, application time, and protocol of the CIMT varied the between studies. However, the intervention procedures to perform CIMT immediately after transcranial direct current stimulation was the same. Transcranial direct current stimulation combined with CIMT was effective in improving upper limb function and activities of daily living in patients with stoke and had a significant effect on cerebral cortex activation. Conclusions : This study provides information on transcranial direct current stimulation combined with CIMT for use by clinical therapists. Further studies are needed to standardize the stimulation time, current intensity, and electrode attachment position. Furthermore, randomized controlled trials, including long-term follow up, are needed for larger populations using the most appropriate CIMT protocol.

• Therapeutic Science for Rehabilitation
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• v.1 no.2
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• pp.23-34
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• 2012

Objective : The purpose of this study was to investigate the effect of task oriented activity and modified constraint induced movement therapy (mCIMT) on Quality of Life (QOL) for patients with stroke. Methods : Thirty stroke patients were participated voluntarily and were assigned randomly into task oriented activity and mCIMT groups. The QOL of both groups were assessed using Stroke Specific Quality of Life (SS-QOL). Results : The QOL showed a statistically meaningful difference for both groups (p<.05), but after the intervention, the both groups showed no statistically meaningful difference in terms of the QOL (p>.05). Conclusion : We found that task oriented activity and mCIMT improve the QOL of patients with stroke through increasing their affected upper extremity function and movement. It is expected that task oriented activity and mCIMT will have a positive effect on the QOL of stroke patients by applying them to clinic with occupational therapy.

• 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.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.2
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• pp.11-20
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• 2020

Purpose : The purpose of this study was to research the effects of dual-hemisphere transcranial direct current stimulation (dual tDCS) and modified constraint-induced movement therapy (mCIMT) to improve upper extremity motor function after stroke. Methods : The study period was from August 2019 to November 2019, and included 24 patients who met the selection criteria. Participants were divided into 2 groups: dual tDCS and mCIMT, and sham dual tDCS and mCIMT group. Dual tDCS and mCIMT group performed mCIMT immediately after applying dual tDCS for 20 minutes, and sham dual tDCS and mCIMT group performed mCIMT immediately after applying sham tDCS for 20 minutes without turning on the power source. Total interventions were conducted 5 times per week for 4 weeks, and mCIMT was conducted for 30 minutes per session for both experimental and control groups. Fugl-Meyer assessment (FMA) and Motor Activity Log scale (MAL) were analyzed before and after 4 weeks of intervention. Results : Both experimental and control groups showed significant changes in FMA, Amount of Use (AOU), and Quality of Movement (QOM) of MAL. When the differences between groups was compared using ANCOVA, the experimental group showed a greater improvement in FMA and AOU of MAL than the control group. Conclusion : In order to enhance the effect of improving upper limb function of stroke patients, dual tDCS could be applied to provide more effective treatment in the clinical setting. Further studies will be needed in larger groups of stroke patients, including long-term follow-up, and multi-group comparisons through the establishment of anodal tDCS and mCIMT, cathodal tDCS, and mCIMT groups to clarify the effects of dual tDCS. In addition, research is needed to establish a protocol for tDCS, and this evidence-based intervention protocol is expected to be used in the clinical setting as an interventional method for various purposes.

• Therapeutic Science for Rehabilitation
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• v.2 no.1
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• pp.13-23
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• 2013

Constraint-Induced Movement Therapy(CIMT) is considered as one of the most interesting upper extremity rehabilitation in the field of neurorehabilitation. CIMT is an intensive training provided in the affected upper limb for 6 hours a day, 5 days a week for 2 weeks, while unaffected arm is restrained for 90% of waking hours. Recently, instead of CIMT, modified Constraint-Induced Movement Therapy(mCIMT) has been applied because of the clinical limitations of CIMT. CIMT or mCIMT studies have used various outcome instruments to measure different aspects of upper limb function after intervention. There are various kinds of evaluation tools to measure different aspects of upper limb function after CIMT intervention. It has been proven that Pediatric Motor Activity Log(PMAL), Quality of Upper Extremities Skills Test(QUEST), Melbourne Assessment of Unilateral Upper Limb Function(MAULF), Assisting Hand Assessment (AHA) are effective. The purpose of this study was to investigate the cortical change in children with hemiplegic cerebral palsy after CIMT. As a result, use-dependent cortical reorganization was revealed. Also, increased activity of the contralateral motor cortex and decreased activity of the ipsilateral cortex were found. It supports the mechanism of cortical reorganization, the principles of neural plasticity and specifically activation of the contralateral cortex, for improving upper limb function after CIMT.

• The Journal of the Korea Contents Association
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• v.16 no.3
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• pp.149-161
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• 2016

The purpose of this study is provided to useful data to establish the Constraint Induced Movement Therapy(CIMT) in clinical plan to more specific for stroke patients. Also It is provided way for further study about CIMT. Methods used a systematic review. Systematic review is a research method that can be presented to the scientific evidence. Data were organized by PICO(Patient, Intervention, Comparison, Outcome). Research using the database Embase and Medline, It was searched for CIMT and Stroke. We selected for a total of 42 studies that meet the purpose of the present study. We was selected for a total of 42 studies that meet the purpose of the present study. Results was that the quality of the study is a systematic review, meta-analyzes, randomized controlled. CIMT studies was based on a high quality level of 50% of the total. The difference between the study period was 42.8%, more research was conducted prior to 2010. CIMT has been used more than mCIMT by to differ 40.5%. It is effective in over 75% of study, regardless of the CIMT intervention. In conclusion, CIMT has an effect on the upper limbs of stroke patients damaged, results will be used as a useful material to develop a CIMT in the clinical treatment plan. In future studies will need to validate studies on the effectiveness of the mCIMT, It will require a review of the effectiveness of validation studies.

• Physical Therapy Korea
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• v.8 no.4
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• pp.91-99
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• 2001

뇌 손상 후 급성기에 기능의 자발적인 회복이 일어나지만 환자들은 환측의 상지를 잘 사용하지 못하게 된다. 그 결과 원하는 움직임을 억제하는 상황을 발생시키는데 이것을 학습 무사용 증후군(learned nonu se syndrome)이라 한다. 이러한 학습 무사용 증후군을 치료하기 위해 억제-유도 치료(constraint-induced therapy)가 고안되었다. 억제-유도 치료는 연속되는 몇 주간에 걸쳐 매일 많은 시간 동안 건측의 상지를 묶어두고 환측 상지를 사용하게 하여 기능을 반복 학습하게 함으로써 기능을 증진시키는 방법이다. 이미 여러 연구자들이 경두개 자기자극(transcranial magnetic stimulation), 움직임 관련 피질전위(movement-related cortical potential), 기능적 자기공명 영상기법(functional magnetic resonance imaging) 등을 통하여 억제-유도 치료 후 운동피질영역에서의 재조직화를 보고함으로써 기능 증진과 관련된 회복 기전을 뒷받침하고 있다. 억제-유도 치료의 영역은 확대되어 뇌졸중, 척수손상, 고관절 치환술 후로 하지에서의 기능증진을 위하여 연구가 진행되고 있으며 특히 뇌졸중 후 실어증 환자에서 새로운 방법으로 제시되고 있다. 따라서, 억제-유도 치료는 신경학적인 손상 후 움직임의 재활에 있어서 치료-유도를 통한 중추신경계의 회복에 효과적으로 작용할 수 있다.

• The Journal of Korean Physical Therapy
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• v.30 no.5
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• pp.159-165
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• 2018

Purpose: The aims of this study were to determine if game-based training with constraint-induced movement therapy (CIMT) is effective in improving the balance ability in female patients with a total knee replacement, and to provide clinical knowledge of CIMT game-based training that allows the application of total knee replacement. Methods: Thirty-six patients who had undergone a total knee replacement were assigned randomly to CIMT game training (n=12), general game training (n=12), and self-exercise (n=12) groups. All interventions were conducted 3 times a week for 4 weeks. All patients used a continuous passive motion machine 5 times a week and 2 times a day for 4 weeks. The visual analog scale (VAS), muscle strength of knee flexion and extension, and range of motion (ROM) of knee flexion and extension were assessed, and the functional reach test (FRT), and timed up and go (TUG) test were performed to evaluate the balance ability. Results: All 3 groups showed significant improvement in the VAS, knee flexion and extension muscle strength, FRT, and TUG test after the intervention (p<0.05). Post hoc analysis revealed significant differences in FRT, and TUG of the CIMT game training group compared to the other group (p<0.05). Conclusion: Although the general game training and CIMT game training improved both the knee extension muscle strength and dynamic balance ability, CIMT game training had a larger effect on dynamic balance control.

• 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.