Abstract
Background: Research continues to support the notion that neuroplastic changes are possible after stroke. There is a continually growing body of evidence indicating that constraint-induced movement therapy (CIMT) encourages neuroplastic changes and is therefore an effective treatment for improving upper extremity (UE) motor function in a select population with hemiparesis. However, CIMT is generally a time-intensive treatment, and it is only performed in a limited number of facilities nationwide. Modified CIMT (mCIMT) has emerged as an alternative to traditional CIMT, but is based on the same principles. Research indicates it can reproduce similarly positive results despite being less expensive and time intensive. Purpose: The aim of this study was to investigate the feasibility of a mCIMT intervention regimen in the home setting, and to determine if it provides a measurable increase in UE motor functioning and quality of life (QOL). Methods: A single participant with chronic stroke UE impairment underwent 6 weeks of a mCIMT regimen of therapy, 1 hour/week, 3x/week. The UE portion of the Fugl-Meyer Assessment of Motor Recovery (FMA) was used to measure motor function. It was administered weekly during the intervention period and included 3 baseline measurements taken over 2 weeks and 4 withdrawal measures recorded weekly over 1 month. The Rand Short Form-36 (SF-36) was recorded as a pretest, posttest, and a 1-month follow up. Results: The participant's FMA scores steadily climbed from 31 to 53 over the intervention period and remained consistent after withdrawal. His SF-36 increased from 50 to 92 over the course of the intervention, and also remained high when retested after 1 month. Discussion: The outcome measures indicated improvements in the motor function of the involved left UE and the participant's overall QOL. The participant also self-reported significant functional improvement, satisfaction, and an overall improved QOL. Conclusion: The treatment was successful in this experiment, but is limited in external validity as it was a single-subject design. The results indicate mCIMT is a plausible and cost-effective form of rehabilitation in the home setting. This study could therefore justify future research into mCIMT, particularly larger randomized controlled trials, to provide further validation.