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Author Notes:

Corresponding Author: Steven L. Wolf, PhD, Center for Rehabilitation Medicine, Emory University School of Medicine, 1441 Clifton Road NE, Atlanta, GA 30322, USA. Email: swolf@emory.edu.

The critical comments offered by Carolee J. Winstein, PhD, PT, FAPTA, on previous drafts of this manuscript are very much appreciated.

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Subjects:

Research Funding:

The data presented in this article were derived from work supported through NIH grant R01 HD37606.

Keywords:

  • constraint-induced therapy
  • Wolf Motor Function Test
  • stroke rehabilitation
  • neuroplasticity
  • task practice
  • upper extremity

The EXCITE Trial: Analysis of "Noncompleted" Wolf Motor Function Test Items

Tools:

Journal Title:

Neurorehabilitation & Neural Repair

Volume:

Volume 26, Number 2

Publisher:

, Pages 178-187

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Objective: This is the first study to examine Wolf Motor Function Test (WMFT) tasks among EXCITE Trial participants that could not be completed at baseline or 2 weeks later. Methods: Data were collected from participants who received constraint-induced movement therapy (CIMT) immediately at the time of randomization (CIMT-I, n = 106) and from those for whom there was a delay of 1 year in receiving this intervention (CIMT-D, n = 116). Data were collected at baseline and at a 2-week time point, during which the CIMT-I group received the CIMT intervention and the CIMT-D group did not. Generalized estimating equation (GEE) analyses were used to examine repeated binary data and count values. Group and visit interactions were assessed, adjusting for functional level, affected side, dominant side, age, and gender covariates. Results: In CIMT-I participants, there was an increase in the proportion of completed tasks at posttest compared with CIMT-D participants, particularly with respect to those tasks requiring dexterity with small objects and total incompletes (P < .0033). Compared with baseline, 120 tasks governing distal limb use for CIMT-I and 58 tasks dispersed across the WMFT for CIMT-D could be completed after 2 weeks. Common movement components that may have contributed to incomplete tasks include shoulder stabilization and flexion, elbow flexion and extension, wrist pronation, supination and ulnar deviation, and pincer grip. Conclusion: CIMT training should emphasize therapy for those specific movement components in patients who meet the EXCITE criteria for baseline motor control.

Copyright information:

© 2012, American Society of Neurorehabilitation

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