Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia.
College of Health Sciences, Gulf Medical University, Ajman 4184, United Arab Emirates.
Int J Environ Res Public Health. 2022 Oct 6;19(19):12809. doi: 10.3390/ijerph191912809.
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.
强制性运动疗法（CIMT）已应用于脑卒中人群以改善下肢功能。然而，其对功能步行的主要成分（如步态速度、平衡和心血管结局）的疗效尚不清楚。本综述旨在描述各种下肢强制性运动疗法（LECIMT）方案对步态速度、平衡和心血管结局的影响。
使用 EBSCO、PubMed、PEDro、Science Direct、Scopus、MEDLINE、CINAHL 和 Web of Science 数据库收集相关文章。本分析纳入了不同恢复阶段的脑卒中人群、年龄>18 岁、接受 LECIMT 治疗的临床试验。本综述仅纳入了 10 项符合纳入标准的研究。使用随机或固定效应模型评估 CIMT 对步态速度和平衡结局的影响。与对照干预相比，CIMT 显示出更好或相似的效果。LECIMT 对步态速度和平衡的影响无统计学意义，平均差异（SMD）分别为 0.13 和 4.94，95%置信区间（CI）分别为（-0.18-0.44）和（-2.48-12.37）。
在这项荟萃分析中，我们观察到尽管多项试验声称 LECIMT 改善下肢功能的疗效，但步态速度和平衡并未显示出有利于 LECIMT 的显著效应量。因此，CIMT 治疗方案应考虑患者的功能需求、CIMT 的核心原则和心肺参数。
