The Effect of Modified Constraint-Induced Movement Therapy(mCIMT) on the Improvement of Upper Motor Function in Adult Stroke Patients Using Meta Analysis

Objective: To conduct a systematic review evaluating the effects of music-based movement therapy on motor function, balance, gait, mental health, and quality of life among individuals with Parkinson’s disease. Data sources: A systematic search of PubMed, Embase, Cochrane Library, Web of Science, PsycINFO, CINAHL, and Physiotherapy Evidence Database was carried out to identify eligible papers published up to December 10, 2020. Review methods: Literature selection, data extraction, and methodological quality assessment were independently performed by two investigators. Publication bias was determined by funnel plot and Egger’s regression test. “Trim and fill” analysis was performed to adjust any potential publication bias. Results: Seventeen studies involving 598 participants were included in this meta-analysis. Music-based movement therapy significantly improved motor function (Unified Parkinson’s Disease Rating Scale motor subscale, MD = −5.44, P = 0.002; Timed Up and Go Test, MD = −1.02, P = 0.001), balance (Berg Balance Scale, MD = 2.02, P < 0.001; Mini-Balance Evaluation Systems Test, MD = 2.95, P = 0.001), freezing of gait (MD = −2.35, P = 0.039), walking velocity (MD = 0.18, P < 0.001), and mental health (SMD = −0.38, P = 0.003). However, no significant effects were observed on gait cadence, stride length, and quality of life. Conclusion: The findings of this study show that music-based movement therapy is an effective treatment approach for improving motor function, balance, freezing of gait, walking velocity, and mental health for patients with Parkinson’s disease.

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Modified Constraint-Induced Movement Therapy Versus Traditional Rehabilitation in Patients With Upper-Extremity Dysfunction After Stroke: A Systematic Review and Meta-Analysis

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2010.12.036 ◽

2011 ◽

Vol 92 (6) ◽

pp. 972-982 ◽

Cited By ~ 70

Author(s):

Yue X. Shi ◽

Jin H. Tian ◽

Ke H. Yang ◽

Yue Zhao

Keyword(s):

Systematic Review ◽

Upper Extremity ◽

Meta Analysis ◽

Movement Therapy ◽

Constraint Induced Movement Therapy

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The effect and optimal parameters of repetitive transcranial magnetic stimulation on motor recovery in stroke patients: a systematic review and meta-analysis of randomized controlled trials

Clinical Rehabilitation ◽

10.1177/0269215519829897 ◽

2019 ◽

Vol 33 (5) ◽

pp. 847-864 ◽

Cited By ~ 5

Author(s):

Huifang Xiang ◽

Jing Sun ◽

Xiang Tang ◽

Kebin Zeng ◽

Xiushu Wu

Keyword(s):

Motor Function ◽

Repetitive Transcranial Magnetic Stimulation ◽

Meta Analysis ◽

Motor Recovery ◽

Controlled Trials ◽

Optimal Parameters ◽

Stroke Patients ◽

Randomized Controlled ◽

Stimulation Parameters ◽

Stroke Population

Objective: The primary aim of this meta-analysis was to evaluate the effects of repetitive transcranial magnetic stimulation (rTMS) on limb movement recovery post-stroke and cortex excitability, to explore the optimal parameters of rTMS and suitable stroke population. Second, adverse events were also included. Data sources: The databases of PubMed, EBSCO, MEDLINE, the Cochrane Central Register of Controlled Trials, EBM Reviews-Cochrane Database, the Chinese National Knowledge Infrastructure, and the Chinese Science and Technology Journals Database were searched for randomized controlled trials exploring the effects of rTMS on limb motor function recovery post-stroke before December 2018. Review methods: The effect sizes of rTMS on limb motor recovery, the effect size of rTMS stimulation parameters, and different stroke population were summarized by calculating the standardized mean difference (SMD) and the 95% confidence interval using fixed/random effect models as appropriate. Results: For the motor function assessment, 42 eligible studies involving 1168 stroke patients were identified. The summary effect size indicated that rTMS had positive effects on limb motor recovery (SMD = 0.50, P < 0.00001) and activities of daily living (SMD = 0.82, P < 0.00001), and motor-evoked potentials of the stimulated hemisphere differed according to the stimulation frequency, that is, the high-frequency group (SMD = 0.57, P = 0.0006), except the low-frequency group (SMD = –0.27, P = 0.05). No significant differences were observed among the stimulation parameter subgroups except for the sessions subgroup ( P = 0.02). Only 10 included articles reported transient mild discomfort after rTMS. Conclusions: rTMS promoted the recovery of limb motor function and changed the cortex excitability. rTMS may be better for early and pure subcortical stroke patients. Regarding different stimulation parameters, the number of stimulation sessions has an impact on the effect of rTMS.

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Effects of constraint-induced movement therapy on motor cortex organization in chronic stroke patients

NeuroImage ◽

10.1016/s1053-8119(18)30857-7 ◽

1998 ◽

Vol 7 (4) ◽

pp. S24

Author(s):

J. Liepert ◽

H. Bauder ◽

M. Sommer ◽

W.H.R. Miltner ◽

C. Dettmers ◽

...

Keyword(s):

Motor Cortex ◽

Movement Therapy ◽

Chronic Stroke ◽

Stroke Patients ◽

Constraint Induced Movement Therapy

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Comparison of two types of Constraint-Induced Movement Therapy in chronic stroke patients: A pilot study

Restorative Neurology and Neuroscience ◽

10.3233/rnn-2009-0524 ◽

2009 ◽

Vol 27 (6) ◽

pp. 675-682 ◽

Cited By ~ 3

Author(s):

Anne Barzel ◽

Joachim Liepert ◽

Kerstin Haevernick ◽

Marion Eisele ◽

Gesche Ketels ◽

...

Keyword(s):

Pilot Study ◽

Movement Therapy ◽

Chronic Stroke ◽

Stroke Patients ◽

Constraint Induced Movement Therapy

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An Application of Upper-Extremity Constraint-Induced Movement Therapy in a Patient With Subacute Stroke

Physical Therapy ◽

10.1093/ptj/79.9.847 ◽

1999 ◽

Vol 79 (9) ◽

pp. 847-853 ◽

Cited By ~ 119

Author(s):

Sarah Blanton ◽

Steven L Wolf

Keyword(s):

Upper Extremity ◽

Motor Function ◽

Internal Capsule ◽

Movement Therapy ◽

Self Report ◽

Full Potential ◽

Posterior Limb ◽

Constraint Induced Movement Therapy ◽

Subacute Stroke

Abstract Background and Purpose. The purpose of this case report is to demonstrate the application of constraint-induced movement therapy with an individual with upper-extremity hemiparesis within 4 months after sustaining a cerebrovascular accident (stroke). Such patients often fail to develop full potential use of their affected upper extremity, perhaps due to a “learned nonuse phenomenon.” Case Description. The patient was a 61-year-old woman with right-sided hemiparesis resulting from an ischemic lacunar infarct in the posterior limb of the left internal capsule. The patient's less-involved hand was constrained in a mitten so that she could not use the hand during waking hours, except for bathing and toileting. On each weekday of the 14-day intervention period, the patient spent 6 hours being supervised while performing tasks using the paretic upper extremity. Pretreatment, posttreatment, and 3-month follow-up outcome measures included the Wolf Motor Function Test and the Motor Activity Log (MAL). Outcomes. For the Wolf Motor FunctionTest, both the mean and median times to complete 16 tasks improved from pretreatment to posttreatment and from posttreatment to follow-up. Results of the MAL indicated an improved self-report of both “how well” and “how much” the patient used her affected limb in 30 specified daily tasks. These improvements persisted to the follow-up. Discussion. Two weeks of constraining the unaffected limb, coupled with practice of functional movements of the impaired limb, may be an effective method for restoring motor function within a few months after cerebral insult. Encouraging improvements such as these strongly suggest the need for a group design that would explore this type of intervention in more detail.

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