Journal of Taiwan Occupational Therapy Research and Practice
Objective: Randomized controlled trials (RCTs) that investigated the effects of constraint-induced therapy (CIT) after stroke have accumulated. This body of literature awaits a quantitative review to inform the evidence-based practice of stroke rehabilitation. This study reported the quantitative results of a systematic review of the literature that includes RCTs comparing CIT to tradition rehabilitation for stroke. Methods: To retrieve RCTs relevant for this review, articles published during 1993 to 2006 were searched from electronic databases. Researchers who have investigated the effects of stroke rehabilitation in Taiwan were contacted for providing local RCTs. The independent variables of the target studies were CIT or modified CIT and traditional rehabilitation. The dependent variables were motor function, kinematic parameters of motor control, daily functioning, neuroplasticity, and quality of life. To be eligible for inclusion, the study design must be randomized controlled trials. The effect size estimates were calculated based on statistics presented in the reports. Results: Fifteen articles were eligible for analysis. The results showed that patients receiving CIT performed better in motor function, kinematic performance (i.e., reaction time and movement units), amount of use and quality of movement of the affected arm, activities of daily living, and quality of life, with moderate to large effects. In addition, the therapy altered brain plasticity based on studies of PET activations. Conclusion: CIT was more effective than traditional rehabilitation in improving motor function, motor control, daily functioning, and quality of life. The brain imaging literature provides evidence for functional reorganization of the brain. Further research may investigate the relative importance of components of CIT to facilitate development of theory-and evidence-based rehabilitation after stroke.