Six hours in the laboratory: a quantification of practice time during constraint-induced therapy (CIT)

To quantify supervised in-laboratory time and practice intensity during the signature protocol specified as 6 hours/day over 10 days for the EXtremity Constraint-Induced Therapy Evaluation (EXCITE) randomized clinical trial.

Retrospective analysis of constraint-induced movement therapy training documentation acquired at the University of Southern California site from EXCITE (n = 38). Training documentation was reviewed and analysed to determine average and between-subject variability of supervised in-laboratory time and actual task-specific practice time for concurrence with the specified constraint-induced movement therapy protocol.

Motor Behavior and Neurorehabilitation Laboratory, Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA.

Data from 38 participants (35 met inclusion criteria) who, upon enrolment in the EXCITE trial, were between 3 and 10 months post stroke and between 47 and 81 years of age.

The training records revealed an average of 64 hours (SD = 2.6) supervised in-laboratory time for 35 participants across 10 days of training. More importantly, the average time on task-specific practice was 3.95 hours per day (SD = 5.7) representing 62% of the in-laboratory time. Supervised in-laboratory time for10 training days was consistent across the sample as was total practice time for days 2-10, with a substantially lower practice time on the initial training day.

Participants tolerated an intense task-specific practice schedule that consisted of approximately two-thirds of the specified minimum 6 hour in-laboratory time and was distributed evenly between adaptive task practice (shaping) and task practice components.