A meta-analysis of constraint-induced movement therapy after stroke
            
                Gyrd Thrane, Oddgeir Friborg , Audny Anke, Bent Indredavik
                Department of Health and Caring Sciences, University of Tromsø, Faculty of Health Sciences, NO-9037 Tromsø, Norway. E-mail: gyrd.thrane@uit.no
                DOI: 10.2340/16501977-1859                
                                
   
            Abstract
            
                Objective: To evaluate the effect of constraint-induced movement therapy in adult stroke patients and to examine the impact of time since stroke and various treatment modalities. 
Data sources: PubMed, EMBASE, Cochrane and PEDro trial registers were searched for clinical trials published before November 2012. 
Study selection: Randomized or quasi-randomized controlled trials of constraint-induced movement therapy lasting 2–7 h/day for 8–28 days were included. 
Data extraction: Measurements were classified into the following categories: arm motor function, arm motor activity, activities of daily living, and participation. A pooled standardized mean difference (SMD) was calculated for each category. Moderators were: trial quality, behavioural techniques, amount of training, time since stroke, shaping, and the nature of the control group. 
Data synthesis: Of 3842 records initially screened 23 trials were included. A small post-treatment effect was found on arm motor function (SMD 0. 28, 95% confidence interval (CI) 0. 11–0. 44). Meanwhile, a moderate effect on arm motor activity was found post-treatment (SMD 0. 51, 95% CI 0. 30–0. 73) and at 3–6 months follow-up (SMD 0. 41, 95% CI 0. 08–0. 74). 
Conclusion: Constraint-induced movement therapy can improve arm motor function and improve arm motor activities and may have a lasting effect on arm motor activity.             
            
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