The EXCITE stroke trial: comparing early and delayed constraint-induced movement therapy

Area of Science:

• Neurorehabilitation
• Stroke recovery research
• Upper extremity motor function

Background:

• Constraint-induced movement therapy (CIMT) improves upper extremity function in stroke survivors.
• Previous studies have not compared early vs. delayed CIMT within the same cohort.

Purpose of the Study:

• To compare functional improvements in stroke survivors receiving CIMT between 3-9 months post-stroke (early group) versus 15-21 months post-stroke (delayed group).

Main Methods:

• 106 participants in the early group received CIMT immediately; 86 in the delayed group received it 1 year later.
• Two weeks of CIMT intervention was administered.
• Evaluations included the Wolf Motor Function Test, Motor Activity Log, and Stroke Impact Scale at multiple time points.

Main Results:

• Both groups improved significantly post-treatment.
• The early CIMT group demonstrated greater initial improvements in the Wolf Motor Function Test and Motor Activity Log.
• Significant differences between groups diminished by 24 months post-enrollment.

Conclusions:

• CIMT is feasible for stroke survivors at both 3-9 months and 15-21 months post-stroke.
• Both early and delayed CIMT groups achieved comparable significant arm motor function recovery at 24 months.
• The timing of CIMT initiation impacts short-term functional gains but not long-term recovery.