Tedla Jaya Shanker, Gular Kumar, Reddy Ravi Shankar, de Sá Ferreira Arthur, Rodrigues Erika Carvalho, Kakaraparthi Venkata Nagaraj, Gyer Giles, Sangadala Devika Rani, Qasheesh Mohammed, Kovela Rakesh Krishna, Nambi Gopal
Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61413, Saudi Arabia.
Postgraduate Program in Rehabilitation Science, University Center Augusto Motta UNISUAM, Rio de Janeiro 21032-060, Brazil.
Healthcare (Basel). 2022 Mar 8;10(3):495. doi: 10.3390/healthcare10030495.
Constraint-induced movement therapy (CIMT) is one of the most popular treatments for enhancing upper and lower extremity motor activities and participation in patients following a stroke. However, the effect of CIMT on balance is unclear and needs further clarification. The aim of this research was to estimate the effect of CIMT on balance and functional mobility in patients after stroke. After reviewing 161 studies from search engines including Google Scholar, EBSCO, PubMed, PEDro, Science Direct, Scopus, and Web of Science, we included eight randomized controlled trials (RCT) in this study. The methodological quality of the included RCTs was verified using PEDro scoring. This systematic review showed positive effects of CIMT on balance in three studies and similar effects in five studies when compared to the control interventions such as neuro developmental treatment, modified forced-use therapy and conventional physical therapy. Furthermore, a meta-analysis indicated a statistically significant effect size by a standardized mean difference of 0.51 (P = 0.01), showing that the groups who received CIMT had improved more than the control groups. However, the meta-analysis results for functional mobility were statistically insignificant, with an effect size of -4.18 (P = 0.16), indicating that the functional mobility improvements in the investigated groups were not greater than the control group. This study's findings demonstrated the superior effects of CIMT on balance; however, the effect size analysis of functional mobility was statistically insignificant. These findings indicate that CIMT interventions can improve balance-related motor function better than neuro developmental treatment, modified forced-use therapy and conventional physical therapy in patients after a stroke.
强制性运动疗法（CIMT）是用于增强中风患者上下肢运动活动及参与度的最常用治疗方法之一。然而，CIMT对平衡的影响尚不清楚，需要进一步阐明。本研究的目的是评估CIMT对中风后患者平衡和功能移动性的影响。在检索了包括谷歌学术、EBSCO、PubMed、PEDro、科学Direct、Scopus和科学网在内的搜索引擎中的161项研究后，我们在本研究中纳入了八项随机对照试验（RCT）。使用PEDro评分验证了纳入的RCT的方法学质量。这项系统评价显示，与神经发育治疗、改良强制性使用疗法和传统物理治疗等对照干预措施相比，三项研究表明CIMT对平衡有积极影响，五项研究显示有类似影响。此外，一项荟萃分析表明，标准化平均差为0.51（P = 0.01），具有统计学显著效应量，表明接受CIMT的组比对照组改善更多。然而，功能移动性的荟萃分析结果在统计学上不显著，效应量为-4.18（P = 0.16），表明研究组的功能移动性改善不大于对照组。本研究结果证明了CIMT对平衡的卓越效果；然而，功能移动性的效应量分析在统计学上不显著。这些发现表明，在中风后患者中，CIMT干预比神经发育治疗、改良强制性使用疗法和传统物理治疗能更好地改善与平衡相关的运动功能。
