Published Online
on March 2, 2006

A more recent version of this article appeared on April 1, 2006

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Submitted on June 6, 2005
Revised on July 21, 2005
Accepted on July 22, 2005

A Placebo-Controlled Trial of Constraint-Induced Movement Therapy for Upper Extremity After Stroke

Edward Taub PhD^*; Gitendra Uswatte PhD; Danna Kay King MSPT; David Morris PhD, PT; Jean E. Crago MSPT; and Anjan Chatterjee MD

From the Departments of Psychology (E.T., G.U.), Rehabilitation Services (D.K.K.), and Physical Therapy (D.M.), University of Alabama at Birmingham; Research Service, Birmingham Veterans Affairs Medical Center, Alabama (E.T.); and Department of Neurology, University of Pennsylvania (A.C.).

^* To whom correspondence should be addressed. E-mail: etaub{at}uab.edu.

Background and Purpose--Constraint-Induced Movement therapy (CI therapy) is a neurorehabilitation technique developed to improve use of the more affected upper extremity after stroke. A number of studies have reported positive effects for this intervention, but an experiment with a credible placebo control group has not yet been published.

Methods--We conducted a placebo-controlled trial of CI therapy in patients with mild to moderate chronic (mean=4.5 years after stroke) motor deficit after stroke. The CI therapy group received intensive training (shaping) of the more affected upper extremity for 6 hours per day on 10 consecutive weekdays, restraint of the less affected extremity for a target of 90% of waking hours during the 2-week treatment period, and application of a number of other techniques designed to produce transfer to the life situation. The placebo group received a program of physical fitness, cognitive, and relaxation exercises for the same length of time and with the same amount of therapist interaction as the experimental group.

Results--After CI therapy, patients showed large (Wolf Motor Function Test) to very large improvements in the functional use of their more affected arm in their daily lives (Motor Activity Log; P<0.0001). The changes persisted over the 2 years tested. Placebo subjects showed no significant changes.

Conclusion--The results support the efficacy of CI therapy for rehabilitating upper extremity motor function in patients with chronic stroke.

Key words: controlled clinical trials • rehabilitation • stroke • treatment outcome

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