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Modified constraint-induced movement therapy for lower extremity intervention on patients with stroke: A Scoping
Liping Zhou1,2, Huaide Chu2, Manting Cao1
1Department of Community Health, Advanced Medical and Dental Institute, University Sains Malaysia, 13200 Kepala Batas, Pulau Pinang, Malaysia.
Background:
Stroke is the main cause of long-term disability, burdening people and healthcare systems. In stroke patients, modified Constraint-Induced Movement Therapy (mCIMT) may improve lower extremity function. Protocol variability complicates efficacy evaluation.
Objectives:
For stroke patients' lower extremity rehabilitation, examine mCIMT safety and effectiveness and identify important protocol components for motor recovery augmentation.
Methods:
An extensive PubMed, Web of Science, Scopus, and PEDro search found clinical studies on mCIMT for lower extremity mobility impairments in adult stroke patients published between January 1, 2000, and November 30, 2023. Constraints, doses, transfer packages, and outcome measures analyzed heterogeneity and study classifications appraised quality.
Results:
36 trials with 931 stroke victims were examined. Heterogeneity prevented clear results on the best mCIMT methods. Studies show that mCIMT improves motor function, functional mobility, balance, lower limb strength, weight-bearing, and walking ability with minor side effects. Physical restraint devices may be unsafe and painful. For safety, behavioral limitations are advised. Instead of training length, task repetitions are a better indication of training intensity and can decrease training time. Transfer packages help transfer training gains to daily activities and preserve long-term effects, as shown by better real-world walking habits and functional mobility during follow-up.
Conclusions:
mCIMT is safe and effective for stroke lower extremity rehabilitation. Behavioral limitations, a specified dose of task repetitions, and patient-specific transfer packages are recommended for mCIMT. Standardizing methods and finding appropriate component combinations to overcome heterogeneity and improve clinical applicability and patient outcomes require further study.
