Reaching Kinematics Improvement after Using Modified Constrained Induced Movement Therapy in Hemiparetic Patients

Background and Purpose: Unsuccessful use of the affected UL in stroke patients may cause“learned nonuse phenomenon,” in which patients habitually relyon their unaffected upper limbto accomplish daily activities. Constraintinduced movement therapy overcoming learned nonuse through restraining of the unaffected limb over an extended period of time incombination with intensive training of specific taskofthe affected UL. The purpose of this study was to determine the effect of modified Constraintinduced movement therapy on reaching kinematics in stroke patients.Patients and Methods: Thirty male ischemic stroke patients included in this study and their age ranged between 45-55 years. Patients were divided randomly into two equal groups. The first group (Group I) received modified constrained induced movement therapy plus a selected physical therapy program. The second group (Group II) received the selected physical therapy program only. Reaching movement kinematics of the affected upper limb was assessed before and after treatment using two-dimensional analysis.Results: Within each group: The first group showed a statistically very highly significant decrease in compensatory trunk displacement and decrease time of reach to grasp after treatment (p= 0.0001 and p=0.0002 respectively). The second group showed a statistically highly significant increase in compensatory trunk displacement (p=0.0004) while there was no significance difference in time of reach to graspafter treatment (p=0.40). Also, there was very highly significant difference of trunk displacement and time of reach to grasp between both groups post treatment. (p=0.0001 and p=0.0004 respectively).Conclusion: Modified constrained induced movement therapy increase movement control and improve reaching movement kinematics in affected limb in stroke patients.