Original articleThe Effects of Constraint-Induced Therapy on Kinematic Outcomes and Compensatory Movement Patterns: An Exploratory Study
Section snippets
Participants
A convenience sample of participants enrolled in a separate randomized controlled CIT study was used for this study. Ten participants (3 female; 5 left cerebral vascular accident) with a mean age ± SD of 61±14.7 years participated and gave written consent in accordance with the policies of the local institutional review board. Table 1 summarizes participant demographics. Participants were recruited from the community and met the following inclusion criteria: at least 9 months poststroke of
Unaffected reach
Data from the unaffected side (n=4; participants 2, 7, 8, 10) are presented to illustrate differences between unaffected and stroke-affected reaching patterns. Figure 2A (top panel) illustrates the reaching strategy of a representative participant (participant 10, presented as a mirror-image) and the segmental contribution to the total reaching movement. With the unaffected arm, the trunk remained relatively stable in a neutral position and contributed very little to the overall reaching
Discussion
A limited number of studies have employed objective and quantitative measures to investigate change in movement patterns after CIT, and these studies have focused primarily on modified CIT protocols and spatiotemporal parameters of movement.15, 16, 18, 21 The goal of our study was to expand on this previous work by examining those parameters that are perhaps most clinically meaningful—for example, how motor patterns and strategies change in relation to common compensatory movements. While we
Conclusions
The results of this study demonstrate that spatiotemporal parameters of movement improved after CIT, and there was greater use of the shoulder during reach. However, while functional capacity and some movement strategies in the hemiparetic arm improved after CIT, participants did not overcome their reliance on common compensatory movement patterns. After CIT, shoulder abduction was more pronounced, and subjects continued to rely on trunk movement to accomplish reach. Based on these findings,
Acknowledgment
We thank Gary Kenyon, MS, for his support of kinematic data collection procedures.
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From a thesis submitted to the Academic Faculty of Colorado State University in partial fulfillment of the requirements for the degree of Master of Science.
Supported by the National Institutes of Health (grant no. 1RO1 HD045751-01A0) and a Scholarship Advancement Award, Department of Occupational Therapy, Colorado State University.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.