The effect of functional stretching exercises on functional outcomes in spastic stroke patients: A randomized controlled clinical trial

Background

Stroke is the biggest cause of disability in adults. Spasticity is a primary impairment of stroke with a highly variable prevalence. In the present research, we aimed to determine the impact of functional stretching exercises on functional outcomes in stroke patients.

Efficacy of modified constraint-induced movement therapy in chronic stroke: a single-blinded randomized controlled trial

OBJECTIVE: To determine efficacy of a modified constraint-induced movement therapy (mCIMT) protocol for patients with chronic stroke. DESIGN: Multiple-baseline, pre-post, single-blinded randomized controlled trial. SETTING: Outpatient clinic. PARTICIPANTS: Seventeen patients who experienced stroke more than 1 year before study entry and who had upper-limb hemiparesis and learned nonuse. INTERVENTION: Seven patients participated in structured therapy sessions emphasizing more affected arm use in valued activities, 3 times a week for 10 weeks. Their less affected arms were also restrained 5d/wk for 5 hours (mCIMT). Four patients received regular therapy with similar contact time to mCIMT. Six patients received no therapy (control). MAIN OUTCOME MEASURES: The Fugl-Meyer Assessment of Motor Recovery (FMA), Action Research Arm (ARA) Test, and Motor Activity Log (MAL). RESULTS: The mCIMT patients exhibited greater motor changes on the FMA and ARA (18.4, 11.4) than regular therapy (6.0, 7.1) or control (-2.9, -4.5). Statistical analyses showed significant differences in motor improvement on the FMA (F(2,12)=11.2, P=.002) and the ARA (F(2,12)=14.0, P=.001). Post hoc analyses showed that, when pretreatment motor differences are controlled, mCIMT resulted in substantially higher posttreatment FMA and ARA scores. Amount and quality of arm use, measured by the MAL, improved only in mCIMT patients. CONCLUSIONS: mCIMT may be an efficacious method of improving function and use of the more affected arms of chronic stroke patients. Findings further affirm that repeated, task-specific practice is critical to reacquisition of function, whereas practice schedule intensity is less critical.     

Inspiratory muscular training in chronic stroke survivors: a randomized controlled trial

Britto RR, Rezende NR, Marinho KC, Torres JL, Parreira VF, Teixeira-Salmela LF. Inspiratory muscular training in chronic stroke survivors: a randomized controlled trial.

Objective

To assess the effectiveness of inspiratory muscular training (IMT) on measures of strength, resistance, functional performance, and quality of life (QOL) for chronic stroke survivors.

Design

Double-blinded randomized controlled trial.

Setting

Research laboratory.

Participants

Subjects (N=21) with stroke (11 men, 10 women; maximal inspiratory pressure [MIP] <90% of predicted values) were randomly assigned to the experimental (n=11) and control groups (n=10); 18 participants completed all testing and training.

Interventions

Interventions were based on home-based training, with resistance adjusted biweekly to 30% of MIP for the experimental group. The control group underwent the same protocol without the threshold resistance valve. Both groups received home training 30 minutes a day 5 times a week for 8 weeks.

Main Outcome Measures

MIP, inspiratory muscular endurance (IME), functional performance, and QOL.

Results

There were significant between-group differences for the MIP and IME measures. Significant changes were observed for only the experimental group for MIP (67.8±14.6 at baseline to 102.2±26.0cmH₂O at posttraining) and IME (31.8±19.3 to 49.2±21.1cmH₂O). No statistically significant differences were observed for measures of functional performance and QOL.

Conclusions

Significant short-term effects of the IMT program for inspiratory strength and endurance were observed in chronic stroke survivors. These findings gave some indications that IMT may benefit people with stroke, and it is feasible to be included in rehabilitation interventions with this population.     

Aerobic exercise versus combined exercise therapy in women with fibromyalgia syndrome: a randomized controlled trial

Sañudo B, Galiano D, Carrasco L, Blagojevic M, de Hoyo M, Saxton J. Aerobic exercise versus combined exercise therapy in women with fibromyalgia syndrome: a randomized controlled trial.

Objective

To investigate the effects of supervised aerobic exercise (AE) and a combined program of supervised aerobic, muscle strengthening, and flexibility exercises (combined exercise [CE]) on important health outcomes in women with fibromyalgia syndrome (FMS).

Design

Randomized controlled trial.

Setting

Community-based supervised intervention.

Participants

Women (N=64) with a diagnosis of FMS according to the American College of Rheumatology criteria.

Intervention

Participants were randomly allocated to 1 of 3 groups: supervised AE, supervised CE, or usual-care control. Exercise sessions were performed twice weekly (45–60min/session) for 24 weeks.

Main Outcome Measures

The primary outcome measure was the Fibromyalgia Impact Questionnaire (FIQ). Exploratory outcome measures were the 36-Item Short-Form Health Survey, Beck Depression Inventory (BDI), aerobic capacity (6-minute walk test), hand-grip strength, and range of motion in the shoulders and hips.

Results

Compliance with both interventions was excellent, with women in the exercise groups attending more than 85% of sessions. A 14% to 15% improvement from baseline in total FIQ score was observed in the exercise groups (P≤.02) and was accompanied by decreases in BDI scores of 8.5 (P<.001) and 6.4 (P<.001) points in the AE and CE groups, respectively. Relative to nonexercising controls, CE evoked improvements in the SF-36 Physical Functioning (P=.003) and Bodily Pain (P=.003) domains and was more effective than AE for evoking improvements in the Vitality (P=.002) and Mental Health (P=.04) domains. Greater improvements also were observed in shoulder/hip range of motion and handgrip strength in the CE group.

Conclusion

Given the equivalent time commitment required for AE and CE, our results suggest that women with FMS can gain additional health benefits by engaging in a similar volume of CE.     

Body weight supported treadmill training versus traditional training in patients dependent on walking assistance after stroke: a randomized controlled trial

Purpose: Treadmill training with body weight support (TTBWS) for relearning walking ability after brain damage is an approach under current investigation. Efficiency of this method beyond traditional training is lacking evidence, especially in patients needing walking assistance after stroke. The objective of this study was to investigate change in walking and transfer abilities, comparing TTBWS with traditional walking training. Methods: A single-blinded, randomized controlled trial was conducted. Sixty patients referred for multi-disciplinary primary rehabilitation were assigned into one of two intervention groups, one received 30 sessions of TTBWS plus traditional training, the other traditional training alone. Daily training was 1?hr. Outcome measures were Functional Ambulation Categories (FAC), Walking, Functional Independence Measure (FIM); shorter transfer and stairs, 10 m and 6-min walk tests. Results: Substantial improvements in walking and transfer were shown within both groups after 5 and 11 weeks of intervention. Overall no statistical significant differences were found between the groups, but 12 of 17 physical measures tended to show improvements in favour of the treadmill approach. Conclusions: Both training strategies provided significant improvements in the tested activities, suggesting that similar outcomes can be obtained in the two modalities by systematic, intensive and goal directed training.

Implications for Rehabilitation

• Treadmill training with body weight support (TTBWS) and traditional gait training were found to be equally effective in improving walking and transfer in patients dependent on walking assistance after stroke.

• However, most outcome measures showed a tendency of improvement in favour of the treadmill group.

• Both training modalities were systematic, goal-directed and intensive, and the time used for training was the same.

• The choice between the two equally effective training alternatives should be based on the patients’ preference, and availability of equipment and resources.

     

Effects of electric stimulation-assisted cycling training in people with chronic stroke

Janssen TW, Beltman JM, Elich P, Koppe PA, Konijnenbelt H, de Haan A, Gerrits KH. Effects of electric stimulation-assisted cycling training in people with chronic stroke.

Objective

To evaluate whether leg cycling training in subjects with chronic stroke can improve cycling performance, aerobic capacity, muscle strength, and functional performance and to determine if electric stimulation (ES) to the contralateral (paretic) leg during cycling has additional effects over cycling without ES.

Design

A randomized controlled trial, with a partial double-blind design.

Setting

A rehabilitation center.

Participants

Twelve stroke patients (range, 18-70y), more than 5 months poststroke, with lower-extremity hemiparesis.

Intervention

Subjects were randomly assigned to groups that performed cycling exercise, one with ES evoking muscle contractions and a control group with ES not evoking muscle contractions. Subjects, blinded for group assignment, trained twice a week for 6 weeks.

Main Outcome Measures

Changes in aerobic capacity and maximal power output, functional performance, and lower-limb muscle strength.

Results

Aerobic capacity and maximal power output significantly increased by 13.8%±19.1% and 38.1%±19.8%, but muscle strength was not significantly enhanced after training. Functional performance improved (ie, scores on the Berg Balance Scale increased by 6.9%±5.8% (P=.000) and the six-minute walk test improved by 14.5%±14.1% (P=.035). There was no significant effect on the Rivermead Mobility Index (P=.165). Training-induced changes were not significantly different between the 2 groups. Changes in cycling performance and aerobic capacity were not significantly related to changes in functional performance.

Conclusions

This study showed that a short cycling training program on a semirecumbent cycle ergometer can markedly improve cycling performance, aerobic capacity, and functional performance of people with chronic stroke. The use of ES had no additional effects in this specific group of subjects with chronic stroke.     

老年抑郁症患者治疗前后血清脑源性神经营养因子水平动态观察

目的 探讨5-羟色胺再摄取抑制剂治疗老年抑郁症患者的临床疗效及治疗前后血清脑源性神经营养因子水平的变化,为研究老年抑郁症的发生机制以及抗抑郁治疗的生物学指标提供依据.方法 将35例老年抑郁症患者设为病例组,抽取同期健康体检者50名设为对照组.病例组口服5-羟色胺再摄取抑制剂治疗,观察8周;于治疗前及治疗8周末采用汉密顿抑郁量表评定临床疗效.病例组于治疗前及治疗8周末,对照组于入组时检测血清脑源性神经营养因子水平,并进行对比分析.结果 (1)病例组治疗8周末汉密顿抑郁量表评分较治疗前显著下降(t=13.02,P＜0.01),显效率71.4%,总有效率88.6%.(2)病例组治疗后血清脑源性神经营养因子水平较治疗前显著升高(t=6.94,P＜0.01),治疗前显著低于对照组(t=8.02,P＜0.01),治疗后与对照组差异无显著性(t=1.62,P＞0.05).(3)病例组不同性别患者治疗前后血清脑源性神经营养因子水平差异均无显著性(P＞0.05).(4)病例组治疗前血清脑源性神经营养因子水平与病程、年龄、治疗前汉密顿抑郁量表评分均无明显相关性(P＞0.05).结论 脑源性神经营养因子可能参与老年抑郁症的病因与治疗机制,并可能成为预测老年抑郁症抗抑郁疗效的生物学指标之一.     

Dual-task exercise improves walking ability in chronic stroke: a randomized controlled trial

Yang YR, Wang RY, Chen YC, Kao MJ. Dual-task exercise improves walking ability in chronic stroke: a randomized controlled trial.

Objective

To examine the effectiveness of a dual-task-based exercise program on walking ability in subjects with chronic stroke.

Design

Single-blind randomized controlled trial.

Setting

General community.

Participants

Twenty-five subjects with chronic stroke who were at least limited community ambulatory subjects (a minimum gait velocity, 58cm/s).

Interventions

Participants were randomized into a control group (n=12) or experimental group (n=13). Subjects in the control group did not receive any rehabilitation training. Subjects in the experimental group underwent a 4-week ball exercise program.

Main Outcome Measures

Gait performance was measured under single task (preferred walking) and tray-carrying task. Gait parameters of interest were walking speed, cadence, stride time, stride length, and temporal symmetry index.

Results

The experimental group showed significant improvement in all selected gait measures except for temporal symmetry index under both task conditions. In the control group, there were no significant changes over the 4-week period for all selected measures. There was a significant difference between groups for all selected gait variables except for temporal symmetry index under both task conditions.

Conclusions

The dual-task-based exercise program is feasible and beneficial for improving walking ability in subjects with chronic stroke.     

Progressive resistance strengthening exercises after stroke: a single-blind randomized controlled trial

OBJECTIVE: To determine the effectiveness of progressive resistance strengthening exercises to improve gross motor function and walking in patients receiving intensive rehabilitation after stroke. DESIGN: Randomized controlled trial. SETTING: Five inpatient rehabilitation programs affiliated with teaching hospitals. PARTICIPANTS: Inclusion criteria included less than 6 months poststroke and recovery of the leg stages 3 to 5 on the Chedoke-McMaster Stroke Assessment (CMSA). INTERVENTIONS: Both groups received conventional physical therapy programs. In addition, the experimental group performed 9 lower-extremity progressive resistance exercises 3 times a week for the duration of their stay, whereas the control group did the same exercises and for the same duration but without resistance. MAIN OUTCOME MEASURES: The Disability Inventory of the CMSA and the 2-minute walk test (2MWT) at baseline, 4 weeks, discharge, and 6 months after discharge. RESULTS: Over the length of stay, the rate of change in the Disability Inventory was.27 points per day in the experimental group and.29 points per day in the control group; the between-group difference was -.02 points per day (95% confidence interval [CI], -.10 to.06; P=.62). At discharge, the rate of change in the 2MWT was -.01 m in the experimental group and.15m in the control group; the between-group difference was -.16 m (95% CI, -.37 to.05; P=.14). CONCLUSIONS: Progressive resistance strengthening exercises as applied in our study were not effective when compared with the same exercises given without resistance.     

Increased serum levels of brain-derived neurotropic factor during migraine attacks: a pilot study

There is a growing body of evidence implicating inflammatory cytokines and brain-derived neurotropic factor (BDNF) in the generation of migraine pain. No previous study evaluated BNDF levels during migraine attacks and there are conflicting results regarding tumor necrosis factor-alpha (TNF-alpha) serum levels. This study compared serum levels of TNF-alpha, soluble TNF receptors 1 and 2 (sTNF-R1 and sTNF-R2), and BDNF during migraine attacks and in headache-free periods. Nine patients with episodic migraine were clinically evaluated during a migraine attack and in a headache-free period. Blood sample of each patient in both occasions was collected and all serum was submitted to TNF-alpha, sTNF-R1, sTNF-R2, and BDNF determination by ELISA. There was no significant difference in the serum levels of TNF-alpha, sTNF-R1 and sTNF-R2 in migraine attack period and headache-free period. BDNF serum levels were significantly higher during migraine attack than in pain-free period. This is the first report showing that BDNF serum levels increase during migraine attack. This reinforces the view that BDNF may be implicated in the physiopathology of migraine.     

Neuromuscular electric stimulation effect on lower-extremity motor recovery and gait kinematics of patients with stroke: a randomized controlled trial

OBJECTIVE: To evaluate the effects of neuromuscular electric stimulation (NMES) of the tibialis anterior muscle on motor recovery and gait kinematics of patients with stroke. DESIGN: Randomized, controlled, assessor-blinded trial. SETTING: Rehabilitation ward and gait laboratory of a university hospital. PARTICIPANTS: A total of 25 consecutive inpatients with stroke (mean age, 55y), all within 6 months poststroke and without volitional ankle dorsiflexion. INTERVENTION: Both the NMES group (n=12) and the control group (n=13) participated in a conventional stroke rehabilitation program, 5 days a week for 4 weeks. The NMES group also received 10 minutes of NMES to the tibialis anterior muscle of the paretic limb. MAIN OUTCOME MEASURES: Brunnstrom stages of motor recovery and kinematic characteristics of gait. RESULTS: Brunnstrom stages improved significantly in both groups (P<.05). In total, 58% of the NMES group and 61% of the control group gained voluntary ankle dorsiflexion. Between-group difference of percentage change was not significant (P>.05). Gait kinematics was improved in both groups, but the difference between groups was not significant. CONCLUSIONS: NMES of the tibialis anterior muscle combined with a conventional stroke rehabilitation program was not superior to a conventional stroke rehabilitation program alone, in terms of lower-extremity motor recovery and gait kinematics.     

Mirror therapy improves hand function in subacute stroke: a randomized controlled trial

Yavuzer G, Selles R, Sezer N, Sütbeyaz S, Bussmann JB, Köseo?lu F, Atay MB, Stam HJ. Mirror therapy improves hand function in subacute stroke: a randomized controlled trial.

Objective

To evaluate the effects of mirror therapy on upper-extremity motor recovery, spasticity, and hand-related functioning of inpatients with subacute stroke.

Design

Randomized, controlled, assessor-blinded, 4-week trial, with follow-up at 6 months.

Setting

Rehabilitation education and research hospital.

Participants

A total of 40 inpatients with stroke (mean age, 63.2y), all within 12 months poststroke.

Interventions

Thirty minutes of mirror therapy program a day consisting of wrist and finger flexion and extension movements or sham therapy in addition to conventional stroke rehabilitation program, 5 days a week, 2 to 5 hours a day, for 4 weeks.

Main Outcome Measures

The Brunnstrom stages of motor recovery, spasticity assessed by the Modified Ashworth Scale (MAS), and hand-related functioning (self-care items of the FIM instrument).

Results

The scores of the Brunnstrom stages for the hand and upper extremity and the FIM self-care score improved more in the mirror group than in the control group after 4 weeks of treatment (by 0.83, 0.89, and 4.10, respectively; all P<.01) and at the 6-month follow-up (by 0.16, 0.43, and 2.34, respectively; all P<.05). No significant differences were found between the groups for the MAS.

Conclusions

In our group of subacute stroke patients, hand functioning improved more after mirror therapy in addition to a conventional rehabilitation program compared with a control treatment immediately after 4 weeks of treatment and at the 6-month follow-up, whereas mirror therapy did not affect spasticity.     

Gait outcomes after additional backward walking training in patients with stroke: a randomized controlled trial

OBJECTIVE: To examine the effectiveness of additional backward walking training on gait outcome of patients post stroke. DESIGN: Randomized controlled trial. SETTING: Medical centre. SUBJECTS: Twenty-five subjects with stroke, who were lower extremity Brunnstrom motor recovery stage at 3 or 4 and were able to walk 11 m with or without a walking aid or orthosis, randomly allocated to two groups, control (n = 12) and experimental (n = 13). INTERVENTIONS: Subjects in both groups participated in 40 min of conventional training programme three times a week for three weeks. Subjects in experimental group received additional 30 min of backward walking training for three weeks at a frequency of three times per week. MAIN MEASURES: Gait was measured using the Stride Analyzer. Gait parameters of interest were walking speed, cadence, stride length, gait cycle and symmetry index. Measures were made at baseline before commencement of training (pre-training) and at the end of the three-week training period (post-training). RESULTS: After a three-week training period, subjects in experimental group showed more improvement than those in control group for walking speed (change score: 8.60 +/- 6.95 versus 3.65 +/- 2.92, p-value = 0.032), stride length (change score: 0.090 +/- 0.076 versus -0.0064 +/- 0.078, p-value = 0.006), and symmetry index (change score: 44.07 +/- 53.29 versus 5.30 +/- 13.91, p-value = 0.018). CONCLUSIONS: This study demonstrated that asymmetric gait pattern in patients post stroke could be improved from receiving additional backward walking therapy.     

Team training and stroke rehabilitation outcomes: a cluster randomized trial

Strasser DC, Falconer JA, Stevens AB, Uomoto JM, Herrin J, Bowen SE, Burridge AB. Team training and stroke rehabilitation outcomes: a cluster randomized trial.

Objective

To test whether a team training intervention in stroke rehabilitation is associated with improved patient outcomes.

Design

A cluster randomized trial of 31 rehabilitation units comparing stroke outcomes between intervention and control groups.

Setting

Thirty-one Veterans Affairs medical centers.

Participants

A total of 237 clinical staff on 16 control teams and 227 staff on 15 intervention teams. Stroke patients (N=487) treated by these teams before and after the intervention.

Intervention

The intervention consisted of a multiphase, staff training program delivered over 6 months, including: an off-site workshop emphasizing team dynamics, problem solving, and the use of performance feedback data; and action plans for process improvement; and telephone and videoconference consultations. Control and intervention teams received site-specific team performance profiles with recommendations to use this information to modify team process.

Main Outcome Measures

Three patient outcomes: functional improvement as measured by the change in motor items of the FIM instrument, community discharge, and length of stay (LOS).

Results

For both the primary (stroke only) and secondary analyses (all patients), there was a significant difference in improvement of functional outcome between the 2 groups, with the percentage of stroke patients gaining more than a median FIM gain of 23 points increasing significantly more in the intervention group (difference in increase, 13.6%; P=.032). There was no significant difference in LOS or rates of community discharge.

Conclusions

Stroke patients treated by staff who participated in a team training program were more likely to make functional gains than those treated by staff receiving information only. Team based clinicians are encouraged to examine their own team. (ClinicalTrials.gov identifier NCT00237757).     

Does extracorporeal shock wave therapy decrease spasticity of ankle plantar flexor muscles in patients with stroke: a randomized controlled trial

Objective To evaluate the effectiveness of radial extracorporeal shock wave therapy on ankle flexor spasticity in stroke survivors and to reveal changes in the fibroelastic components of muscle.Design Randomized controlled trial.Setting Inpatient neuro-rehabilitation clinic of a university hospital.Participants Stroke patients with ankle flexor spasticity.Interventions Patients were randomized to three groups; radial extracorporeal shock wave therapy, sham, or control. Active and sham therapy we...     

氟西汀对缺血性脑卒中患者血清脑源性神经营养因子水平的影响及临床疗效观察

目的观察氟西汀治疗缺血性脑卒中患者血清脑源性神经营养因子(BDNF)的变化及神经运动功能恢复情况。方法将60例缺血性脑卒中的患者随机分为氟西汀组和对照组,2组患者均同时接受物理治疗。采用酶联免疫吸附法(ELISA)测定治疗前后BDNF的变化,并与对照组比较;用改良Barthel指数(MBI)和简化Fug-lMeyer运动功能量表(FMA)评定2组患者的日常生活活动能力(ADL)和运动功能。结果治疗3个月后,氟西汀组BDNF浓度显著高于治疗前及对照组(P<0.05);治疗后2组MBI及FMA评分均有改善(P<0.05),且氟西汀治疗组疗效优于对照组(P<0.05)。结论缺血性脑卒中患者早期给氟西汀和物理治疗后可促进其运动功能的恢复,提高日常生活活动能力,这种效应可能是通过提高BDNF的浓度,促进神经元再生和对抗神经元损伤后凋亡而发挥作用。     

Water-based exercise for cardiovascular fitness in people with chronic stroke: a randomized controlled trial

OBJECTIVE: To evaluate the effect of an 8-week, water-based exercise program (experimental group) with that of an upper-extremity function program (control group) to increase cardiovascular fitness within a community setting for people with stroke. DESIGN: Single-blind randomized controlled trial. SETTING: Public community center. PARTICIPANTS: A volunteer sample of 12 community-dwelling people with stroke with mild to moderate residual motor deficits. INTERVENTION: Study subjects participated in group exercise programs for 1 hour, 3 times a week for 8 weeks. The experimental group exercised in chest-deep water at targeted heart rates. The control group performed arm and hand exercises while sitting.Main outcome measures The primary outcome measure was cardiovascular fitness (V(O2)max). Secondary measures were maximal workload, muscle strength, gait speed, and the Berg Balance Scale score. RESULTS: The experimental group attained significant improvements over the control group in cardiovascular fitness, maximal workload, gait speed, and paretic lower-extremity muscle strength. The relatively short program (8 wk) of water-based exercise resulted in a 22% improvement in cardiovascular fitness in a small group of people with stroke who had relatively high function. CONCLUSIONS: A water-based exercise program undertaken as a group program may be an effective way to promote fitness in people with stroke.     

Kinematic and clinical analyses of upper-extremity movements after constraint-induced movement therapy in patients with stroke: a randomized controlled trial

OBJECTIVE: To study the effects of constraint-induced movement therapy (CIMT) relative to traditional intervention on motor-control strategies for upper-arm reaching and motor performance at the impairment and functional levels in stroke patients. DESIGN: Two-group randomized controlled trial (RCT); pretreatment and posttreatment measures. SETTING: Rehabilitation clinics. PARTICIPANTS: Forty-seven stroke patients (mean age, 55y) 3 weeks to 37 months postonset of a first-ever cerebrovascular accident. INTERVENTIONS: Forty-seven patients received either CIMT (restraint of the less affected hand combined with intensive training of the more affected upper extremity) or traditional intervention (control treatment) during the study. The treatment intensity was matched between the 2 groups (2h/d, 5d/wk for 3wk). MAIN OUTCOME MEASURES: Outcomes were evaluated using (1) kinematic variables of reaching movement used to describe the control strategies for reaching, (2) the Fugl-Meyer Assessment (FMA) of motor-impairment severity, and (3) the Motor Activity Log (MAL) evaluating the functional ability of the upper extremity. RESULTS: After treatment, the CIMT group showed better strategies of reaching control than the control group (P<.03). The CIMT group also showed less motor impairment on the FMA (P=.019) and higher functional ability on the MAL (P<.001). CONCLUSIONS: This study is the first RCT to show differences in motor-control strategies as measured by kinematic variables after CIMT versus traditional intervention. In addition to improving motor performance at the impairment and functional levels, CIMT conferred therapeutic benefits on control strategies determined by kinematic analysis.