Longer versus shorter daily constraint-induced movement therapy of chronic hemiparesis: an exploratory study.

OBJECTIVE To evaluate and compare the effects of 3-hour versus 6-hour daily training sessions in constraint-induced movement therapy (CIMT). DESIGN Intervention study, 2-group randomized trial; baseline, pretreatment, and posttreatment measures; 1-month follow-up (weekly measures). SETTING University department of psychology in Germany. PARTICIPANTS A convenience sample of 15 adults with chronic hemiparesis (13 stroke, 2 traumatic brain injury). INTERVENTION CIMT (14 consecutive days; constraint of unaffected hand for a target of 90% of waking hours) with either 6 hours (6h/d group, n=7) or 3 hours (3h/d group, n=8) of shaping training with the affected hand per day. MAIN OUTCOME MEASURES The Motor Activity Log and Wolf Motor Function Test. RESULTS Significant improvements in motor function in the laboratory and increased use of the affected hand in the real-world environment were found in both groups. The beneficial effects were significantly greater in the 6h/d group than in the 3h/d group. CONCLUSION The 3-hour CIMT training schedule significantly improved motor function in chronic hemiparesis, but it was less effective than the 6-hour training schedule.