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Modified Constraint-Induced Therapy in Chronic Stroke

Page, Stephen J. PhD; Sisto, Sue Ann PT, PhD; Levine, Peter BA, PTA

American Journal of Physical Medicine & Rehabilitation: November 2002 - Volume 81 - Issue 11 - p 870-875
Case Study: Stroke
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Page S, Sisto SA, Levine P: Modified constraint-induced therapy in chronic stroke. Am J Phys Med Rehabil 2002;81:870–875.

Although efficacious, constraint-induced therapy may be difficult to implement in some outpatient settings. This case study examined the effectiveness of modified constraint-induced therapy administered to a patient with chronic stroke, learned nonuse, and a stable motor deficit in his dominant upper limb. The Fugl-Meyer Assessment of Motor Recovery and Action Research Arm Test were administered twice before intervention, and the Motor Activity Log and actigraphy were administered once. The patient then participated in half-hour, structured physical and occupational therapy sessions, emphasizing affected arm use, three times per week for 10 wk. It was concluded that modified constraint-induced therapy may be an effective method of improving affected arm function and use in chronic stroke patients exhibiting learned nonuse.

From the Kessler Medical Rehabilitation Research and Education Corporation, West Orange, New Jersey, (SJP, SAS, PL); and the Department of Physical Medicine and Rehabilitation, The University of Medicine and Dentistry/New Jersey Medical School, Newark, New Jersey (SJP, SAS).

Supported by a grant from the Wallerstein Foundation for Geriatric Life Improvement (S. Page).

All correspondence and requests for reprints should be addressed to Stephen J. Page, PhD, Director of Research and Assistant Professor, Department of Physical Medicine and Rehabilitation, University of Cincinnati College of Medicine, 202 Goodman Drive, Suite 275, Cincinnati, OH 45267.

© 2002 Lippincott Williams & Wilkins, Inc.