Effect of forced use of the upper extremity of a hemiplegic patient on changes in function. A single-case design

This study was designed to examine the effect of forced use of the affected upper extremity of a hemiplegic patient on the quantity, quality, and efficiency of functional behaviors. The patient was a woman with right hemiplegia of 18 months' duration. The study was divided into three one-week phases: an initial base-line, and experimental, and a second base-line phase. Base-line scores of frequency, quality, and time were recorded for completion of functional tasks. During the experimental phase, the patient's intact upper extremity was restrained. The efficiency and quality of movement scores did not reflect changes related to the period of restraint; however, the frequency of purposeful behaviors and the patient's functional use of her affected extremity increased during the experimental phase. The relationship of forced use to recovery of function in hemiplegia remains uncertain.