Effects of modified constraint-induced movement therapy on the lower extremities in patients with stroke: a pilot study

Abstract

Purpose: This study aimed to qualify the improvements of modified constraint-induced movement therapy (m-CIMT) on the lower limb of stroke patients via assessing the centre of mass (COM) displacement and the basic gait parameters.

Methods: A total of 22 hemiplegic patients after stroke with first-time clinical cerebral infarction or haemorrhagic cerebrovascular accident were included in this study from May to December, 2014. The patients were randomly divided into m-CIMT group and the conventional therapy group (control group), and received corresponding training for five days/week for four weeks. The COM displacement and gait parameters were assessed by three-dimensional segmental kinematics method in pre-intervention and post- intervention therapy.

Results: After four weeks of m-CIMT, the COM displacement on sagittal plane of paretic leg during stance phase was increased (pre: 91.04 ± 4.39 cm, post: 92.38 ± 4.58 cm, p < 0.05) and swing range of frontal plane was remarkably decreased (pre: 10.15 ± 3.05 cm, post: 7.83 ± 1.90 cm, p < 0.001). Meantime, the normalised swing range of COM in m-CIMT was superior to that in control group. Moreover, the gait parameters, including velocity (0.27 m/s), step width (0.10 m), step length (0.22 m) and swing time percentage (29.80%), were significantly improved by post-interventions of m-CIMT (p < 0.05).

Conclusion: The m-CIMT intervention improves the COM displacement in sagittal and frontal plane, as well as gait parameters. These suggest that m-CIMT intervention may be feasible and effective for the rehabilitation of hemiplegic gait.

Implications for Rehabilitation

• Segmental kinematics method was used to estimate the displacement of the COM.

• m-CIMT interventions improved the COM displacement of patients after stroke.

• m-CIMT interventions improved the hemiplegic gait parameters.

Keywords:

• Centre of mass
• constraint-induced movement therapy
• gait
• stroke

Declaration of interest

This study was supported by biological medicine major projects of Shanghai Science and Technology Commission (Grant No. 10DZ1950800) and Provincial Key Laboratory Open Fund of Shanghai University of Sport (Grant No. YZ201205). We wish to express our warm thanks to those who kindly participated in the subjects and their families, all staff of biomechanics laboratory and the workers of rehabilitation medicine who gave us help in the process of collecting the clinical data.