Longer versus shorter daily constraint-induced movement therapy of chronic hemiparesis: an exploratory study

OBJECTIVE: To evaluate and compare the effects of 3-hour versus 6-hour daily training sessions in constraint-induced movement therapy (CIMT). DESIGN: Intervention study, 2-group randomized trial; baseline, pretreatment, and posttreatment measures; 1-month follow-up (weekly measures). SETTING: University department of psychology in Germany. PARTICIPANTS: A convenience sample of 15 adults with chronic hemiparesis (13 stroke, 2 traumatic brain injury). INTERVENTION: CIMT (14 consecutive days; constraint of unaffected hand for a target of 90% of waking hours) with either 6 hours (6h/d group, n=7) or 3 hours (3h/d group, n=8) of shaping training with the affected hand per day. MAIN OUTCOME MEASURES: The Motor Activity Log and Wolf Motor Function Test. RESULTS: Significant improvements in motor function in the laboratory and increased use of the affected hand in the real-world environment were found in both groups. The beneficial effects were significantly greater in the 6h/d group than in the 3h/d group. CONCLUSION: The 3-hour CIMT training schedule significantly improved motor function in chronic hemiparesis, but it was less effective than the 6-hour training schedule.