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Impact of Constraint-Induced Movement Therapy (CIMT) on Functional Ambulation in Stroke Patients—A Systematic Review and Meta-Analysis

Author

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  • Ravi Shankar Reddy

    (Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia)

  • Kumar Gular

    (Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia)

  • Snehil Dixit

    (Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia)

  • Praveen Kumar Kandakurti

    (College of Health Sciences, Gulf Medical University, Ajman 4184, United Arab Emirates)

  • Jaya Shanker Tedla

    (Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia)

  • Ajay Prashad Gautam

    (Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia)

  • Devika Rani Sangadala

    (Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia)

Abstract

Constraint-induced movement therapy (CIMT) has been delivered in the stroke population to improve lower-extremity functions. However, its efficacy on prime components of functional ambulation, such as gait speed, balance, and cardiovascular outcomes, is ambiguous. The present review aims to delineate the effect of various lower-extremity CIMT (LECIMT) protocols on gait speed, balance, and cardiovascular outcomes. Material and methods: The databases used to collect relevant articles were EBSCO, PubMed, PEDro, Science Direct, Scopus, MEDLINE, CINAHL, and Web of Science. For this analysis, clinical trials involving stroke populations in different stages of recovery, >18 years old, and treated with LECIMT were considered. Only ten studies were included in this review, as they fulfilled the inclusion criteria. The effect of CIMT on gait speed and balance outcomes was accomplished using a random or fixed-effect model. CIMT, when compared to controlled interventions, showed superior or similar effects. The effect of LECIMT on gait speed and balance were non-significant, with mean differences (SMDs) of 0.13 and 4.94 and at 95% confidence intervals (Cis) of (−0.18–0.44) and (−2.48–12.37), respectively. In this meta-analysis, we observed that despite the fact that several trials claimed the efficacy of LECIMT in improving lower-extremity functions, gait speed and balance did not demonstrate a significant effect size favoring LECIMT. Therefore, CIMT treatment protocols should consider the patient’s functional requirements, cardinal principles of CIMT, and cardiorespiratory parameters.

Suggested Citation

  • Ravi Shankar Reddy & Kumar Gular & Snehil Dixit & Praveen Kumar Kandakurti & Jaya Shanker Tedla & Ajay Prashad Gautam & Devika Rani Sangadala, 2022. "Impact of Constraint-Induced Movement Therapy (CIMT) on Functional Ambulation in Stroke Patients—A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 19(19), pages 1-16, October.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:19:p:12809-:d:934951
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    References listed on IDEAS

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    1. A. E. Ades & G. Lu & J. P. T. Higgins, 2005. "The Interpretation of Random-Effects Meta-Analysis in Decision Models," Medical Decision Making, , vol. 25(6), pages 646-654, November.
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    1. Kumar Gular & Viswanathan Sivasubramanian & Ravi Shankar Reddy & Jaya Shanker Tedla & Snehil Dixit, 2022. "The Mediating Effect of Age, Gender, and Post-Stroke Duration on the Association between Trunk and Upper Limb Recovery in Subacute Stroke Population: A Cross-Sectional Study with Mediation Analysis," IJERPH, MDPI, vol. 19(23), pages 1-12, November.

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