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The Effects of Constraint-Induced Therapy on Precision Grip: A Preliminary Study

School of Applied Physiology, Georgia Institute of Technology, Atlanta, GA, Atlanta VA Rehab R & D, Atlanta, GA, jay.alberts{at}ap.gatech.edu

Andrew J. Butler

Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA

Steven L. Wolf

Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA

Objective. This preliminary study examines the effects of a 2-week constraint-induced therapy (CIT) intervention on the force-producing capabilities of the hemiparetic hand during the performance of a functional dexterous manipulation task. Methods. A 6-degree-of-freedom force/torque transducer that was embedded into the handle of a key allowed for the quantification of grasping forces and torques produced during the performance of a functional key-turning task. Clinical and kinetic data were collected from 10 subacute patients (3-9 months poststroke) who were participating in an ongoing national clinical study (EXCITE trial) examining the effects of CIT on upper extremity motor performance. Investigators were blinded to treatment designation. Five patients receiving treatment immediately completed 2 weeks of intensive CIT, whereas a group randomized to treatment 1 year later did not receive any therapy during a similar 2-week span. Results .Results indicated that 4 of the 5 patients in the CIT group, compared to the delayed group, showed significant clinical improvements in hand function, increased maximum precision grip force, improved force and torque regulation, and reduced variability in rate of force production during task performance. Conclusions. Improved force control may be a mechanism contributing to the observed improvements in dexterous function in those patients undergoing CIT.

Key Words: Constraint-induced therapy • Precision Grip • Dexterous function

Neurorehabilitation and Neural Repair, Vol. 18, No. 4, 250-258 (2004)
DOI: 10.1177/1545968304271370


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