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Author Notes:

Corresponding Author: Steven L. Wolf, Ph.D., PT, FAPTA, EXCITE Trial Principal Investigator, Center for Rehabilitation Medicine, Emory University School of Medicine, 1441 Clifton Road NE, Atlanta, GA 30322 USA; Phone: 404-712-4801; Fax: 404-712-5895, Email: swolf@emory.edu

We thank our project coordinators, evaluators, and trainers at all the EXCITE locations for their tireless and dedicated efforts throughout this trial.

SLW made primary contributions to the drafting and approval of the final manuscript as well as to the conceptualization and rationale of the study and interpretation of the study.

ET made primary contributions to the conceptualization and rationale of the study as well as drafting and approval of the manuscript.

JPM and PT made primary contributions to data analyses and drafting of the manuscript.

CW, GU, DM, SB, DL and PC contributed primarily to the interpretation of the results and drafting and approval of the manuscript.

We have no conflicts of interest.

Subjects:

Research Funding:

The project was funded by National Institutes of Health Grant No HD37606 from the Center for Medical Rehabilitation Research and the National Institute of Neurology Diseases and Stroke.

Retention of upper limb function in stroke survivors who have received constraint-induced movement therapy: the EXCITE randomised trial

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Journal Title:

Lancet Neurology

Volume:

Volume 7, Number 1

Publisher:

, Pages 33-40

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Background Constraint-Induced Movement therapy (CIMT) uses a variety of treatment components, including restricted use of the better upper extremity, to promote increased use of the contralesional limb for many hours each weekday over two consecutive weeks. The EXCITE Trial demonstrated the efficacy of this intervention for patients 3-9 months post-stroke who were followed for the next 12 months. We assessed the retention of improvements through 24 months. Method Measurements were made every four months for impaired upper extremity function (Wolf Motor Function Test - WMFT and Motor Activity Log - MAL) and health related quality of life (Stroke Impact Scale - SIS) amongst 106/222 participants randomized into one arm of the EXCITE Trial in which they received CIMT rather than usual and customary care. Findings There was no observed regression from the treatment effects observed at 12 months after treatment during the next 12 months for the primary outcome measures of WMFT and MAL. In fact, the additional changes were in the direction of increased therapeutic effect. For the strength components of the WMFT the changes were significant (P < .05) Secondary outcome variables, including the SIS, exhibited a similar pattern. Interpretation Mild to moderately impaired patients who are 3-9 months post-stroke demonstrate substantial improvement in functional use of the paretic upper extremity and quality of life 2 years after receiving a 2-week CIMT intervention. Thus this intervention has persistent benefits.

Copyright information:

© 2008 Elsevier Ltd. All rights reserved.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommerical-NoDerivs 3.0 Unported License (http://creativecommons.org/licenses/by-nc-nd/3.0/).

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