Improvement of gait and balance function in chronic post-stroke patients induced by Lower Extremity – Constraint Induced Movement Therapy: a randomized controlled clinical trial

ABSTRACT

Objective

To evaluate the effects of Lower Extremity – Constraint Induced Movement Therapy on gait function and balance in chronic hemiparetic patients.

Methods

Randomized, controlled, single-blinded study. We recruited chronic post stroke patients and allocated them to Lower Extremity – Constraint Induced Movement Tharapy (LE-CIMT) or Control Group. The LE-CIMT group received this protocol 2.5 hour/day for 15 followed days, including: 1) intensive supervised training, 2) use of shaping as a strategy for motor training, and 3) application of a transfer package. The control group received conventional physiotherapy for 2.5 hours/day for 15 followed days. Outcomes were assessed at baseline, after the interventions, and after 6 months, through 6-minute walk test and Mini-Balance Evaluation Systems Test; 10-meter walk test, Timed Up and Go, 3-D gait analysis, and Lower Extremity – Motor Activity Log.

Results

LE-CIMT was superior on the Assistance and confidence subscale of Lower Extremity – Motor Activity Log, Mini-BESTest and 6-minute walk test. The effect size for all outcomes was small when comparing both groups. LE-CIMT showed clinically significant differences in daily activities, balance, and gait capacity, with no clinically significant difference for spatiotemporal parameters.

Conclusion

The LE-CIMT protocol had positive outcomes on balance, performance, and confidence perception.

KEYWORDS:

• Stroke
• constraint induced movement therapy
• gait
• balance
• hemiparesis

Disclosure statement

Two authors of this study, Elaine Menezes-Oliveira and Gabriela da Silva Matuti, declare a conflict of interest as they are currently instructors on the formation course in Constraint Induced Movement Therapy here in Brazil.

Trial registration

http://www.ensaiosclinicos.gov.br (Register Number: RBR-467cv6). ‘Effects of Lower Extremities – Constraint Induced Therapy on gait and balance function in chronic hemipretic post-stroke patients.’

List of Abbreviations

LE-CIMT	=	Lower Extremity – Constraint Induced Movement Tharapy
6minWT	=	6-minute walk test
Mini-BESTest	=	Mini-Balance Evaluation Systems Test
10mWT	=	10-meter walk test
TUG	=	Timed Up and Go
3-DGA	=	3-D gait analysis
LE-MAL	=	Lower Extremity – Motor Activity Log
GDI	=	Gait Deviation Index
MDC	=	minimal detectable change

Additional information

Funding

The author(s) reported thereis no funding associated with the work featured in this article.