Effects of Two Different Modes of Task Practice during Lower Limb Constraint-Induced Movement Therapy in People with Stroke: A Randomized Clinical Trial

Abstract

Background. Constraint-induced movement therapy (CIMT) is used for the rehabilitation of motor function after stroke. Objectives. The aim of this study was to compare the effects of lower limb CIMT that uses number of repetition of tasks with the one that uses number of hours of practice. Method. The study was a randomized clinical trial approved by the Ethics Committee of Kano State Ministry of Health. Fifty-eight people with stroke participated in the study. Groups 1 and 2 performed daily 600 repetitions and 3 hours of task practice, respectively, 5 times weekly for 4 weeks. Motor impairment (primary outcome), balance, functional mobility, knee extensor spasticity, walking speed and endurance, and exertion before and after commencement of activities were assessed at baseline and postintervention. The data was analyzed using Friedmann and Mann-Whitney <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"><a:mi>U</a:mi></a:math> tests. Result. The results showed that there was only significant difference ( <c:math xmlns:c="http://www.w3.org/1998/Math/MathML" id="M2"><c:mi>p</c:mi><c:mo>&lt;</c:mo><c:mn>0.05</c:mn></c:math> ) in knee extensor spasticity (group 1 ( <e:math xmlns:e="http://www.w3.org/1998/Math/MathML" id="M3"><e:mtext>median</e:mtext><e:mo>=</e:mo><e:mn>0</e:mn><e:mfenced open="(" close=")"><e:mrow><e:mn>0</e:mn></e:mrow></e:mfenced></e:math> , <i:math xmlns:i="http://www.w3.org/1998/Math/MathML" id="M4"><i:mtext>mean</i:mtext><i:mtext> </i:mtext><i:mi mathvariant="normal">rank</i:mi><i:mo>=</i:mo><i:mn>27.50</i:mn></i:math> ); group 2 ( <l:math xmlns:l="http://www.w3.org/1998/Math/MathML" id="M5"><l:mtext>median</l:mtext><l:mo>=</l:mo><l:mn>0</l:mn><l:mfenced open="(" close=")"><l:mrow><l:mn>0</l:mn></l:mrow></l:mfenced></l:math> , <p:math xmlns:p="http://www.w3.org/1998/Math/MathML" id="M6"><p:mtext>mean</p:mtext><p:mtext> </p:mtext><p:mi mathvariant="normal">rank</p:mi><p:mo>=</p:mo><p:mn>31.64</p:mn></p:math> )), exertion before commencement of activities (group 1 ( <s:math xmlns:s="http://www.w3.org/1998/Math/MathML" id="M7"><s:mtext>median</s:mtext><s:mo>=</s:mo><s:mn>0</s:mn><s:mfenced open="(" close=")"><s:mrow><s:mn>0.5</s:mn></s:mrow></s:mfenced></s:math> , <w:math xmlns:w="http://www.w3.org/1998/Math/MathML" id="M8"><w:mtext>mean</w:mtext><w:mtext> </w:mtext><w:mi mathvariant="normal">rank</w:mi><w:mo>=</w:mo><w:mn>21.90</w:mn></w:math> ); group 2 ( <z:math xmlns:z="http://www.w3.org/1998/Math/MathML" id="M9"><z:mtext>median</z:mtext><z:mo>=</z:mo><z:mn>1</z:mn><z:mfenced open="(" close=")"><z:mrow><z:mn>0.5</z:mn></z:mrow></z:mfenced></z:math> , <db:math xmlns:db="http://www.w3.org/1998/Math/MathML" id="M10"><db:mtext>mean</db:mtext><db:mtext> </db:mtext><db:mi mathvariant="normal">rank</db:mi><db:mo>=</db:mo><db:mn>37.64</db:mn></db:math> )), and exertion after commencement of activities (group 1 ( <gb:math xmlns:gb="http://www.w3.org/1998/Math/MathML" id="M11"><gb:mtext>median</gb:mtext><gb:mo>=</gb:mo><gb:mn>1</gb:mn><gb:mfenced open="(" close=")"><gb:mrow><gb:mn>1</gb:mn></gb:mrow></gb:mfenced></gb:math> , <kb:math xmlns:kb="http://www.w3.org/1998/Math/MathML" id="M12"><kb:mtext>mean</kb:mtext><kb:mtext> </kb:mtext><kb:mi mathvariant="normal">rank</kb:mi><kb:mo>=</kb:mo><kb:mn>20.07</kb:mn></kb:math> ); group 2 ( <nb:math xmlns:nb="http://www.w3.org/1998/Math/MathML" id="M13"><nb:mtext>median</nb:mtext><nb:mo>=</nb:mo><nb:mn>1</nb:mn><nb:mfenced open="(" close=")"><nb:mrow><nb:mn>0</nb:mn></nb:mrow></nb:mfenced></nb:math> , <rb:math xmlns:rb="http://www.w3.org/1998/Math/MathML" id="M14"><rb:mtext>mean</rb:mtext><rb:mtext> </rb:mtext><rb:mi mathvariant="normal">rank</rb:mi><rb:mo>=</rb:mo><rb:mn>39.61</rb:mn></rb:math> ) postintervention in favour of the experimental group (group 1)). Conclusion. The group 1 protocol is more effective at improving outcomes after stroke.

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