1 University of Alabama at Birmingham, Birmingham, AL, USA.
Neurorehabil Neural Repair. 2018 Mar;32(3):223-232. doi: 10.1177/1545968318761050.
Constraint-Induced Movement therapy (CIMT) has controlled evidence of efficacy for improving real-world paretic limb use in non-progressive physically disabling disorders (stroke, cerebral palsy).
This study sought to determine whether this therapy can produce comparable results with a progressive disorder such as multiple sclerosis (MS). We conducted a preliminary phase II randomized controlled trial of CIMT versus a program of complementary and alternative medicine (CAM) treatments for persons with MS, to evaluate their effect on real-world disability.
Twenty adults with hemiparetic MS underwent 35 hours of either CIMT or CAM over 10 consecutive weekdays. The primary clinical outcome was change from pretreatment on the Motor Activity Log (MAL).
The CIMT group improved more on the MAL (2.7 points, 95% confidence interval 2.2-3.2) than did the CAM group (0.5 points, 95% confidence interval -0.1 to 1.1; P < .001). These results did not change at 1-year follow-up, indicating long-term retention of functional benefit for CIMT. The treatments were well tolerated and without adverse events.
These results suggest that CIMT can increase real-world use of the more-affected arm in patients with MS for at least 1 year.
ClinicalTrials.gov NCT01081275.
强制性运动疗法（CIMT）已被证实对改善非进行性肢体运动障碍性疾病（如中风和脑瘫）患者的日常生活活动能力具有显著疗效。
本研究旨在探讨该疗法在多发性硬化症（MS）等进行性疾病中是否能取得类似的效果。我们对 CIMT 与补充替代医学（CAM）治疗方案进行了一项初步的 II 期随机对照试验，以评估其对日常生活能力的影响。
20 名偏瘫型 MS 患者连续 10 个工作日接受 35 小时的 CIMT 或 CAM 治疗。主要临床结局指标为运动日志（MAL）治疗前后的变化。
CIMT 组 MAL 评分改善更为显著（2.7 分，95%置信区间 2.2-3.2），而 CAM 组仅改善 0.5 分（95%置信区间 -0.1 至 1.1；P <.001）。1 年随访时结果仍保持不变，表明 CIMT 可长期保留功能获益。两种治疗方法均耐受良好，无不良反应。
这些结果表明，CIMT 可增加 MS 患者日常生活中患肢的使用频率，至少可持续 1 年。
ClinicalTrials.gov NCT01081275。
