Effect and appropriate restriction period of constraint-induced movement therapy in hemiparetic patients with brain injury: a brief report.

OBJECTIVE: To investigate the effect on fine motor ability and the appropriate restriction period of constraint-induced movement therapy in hemiparetic patients with brain injury.

DESIGN: Nine chronic hemiparetic patients with brain injury were studied. After confirming the cessation of further recovery of fine motor ability by Purdue pegboard test and motor function by the Medical Research Council for three consecutive weeks, the affected hand was restricted with an opposition restriction orthosis. The fine motor ability of the affected hand was assessed weekly using Purdue pegboard test and the orthosis was taken off when the Purdue pegboard score showed no further increase over three consecutive weeks.

RESULTS: Purdue pegboard score increased in all patients. The mean post-treatment Purdue pegboard score (10.7) was significantly increased over that of pre-treatment (8.7) (p < 0.05). The mean restriction period was 3.6 weeks (range, 2 to 5 weeks).

CONCLUSION: Constraint-induced movement therapy is an effective therapeutic method to improve the fine motor ability of the hemiparetic hand of brain-injured patients. It can be assumed that the appropriate restriction period is best decided individually, on a case by case basis, according to the time that maximizes the hand function of the affected hand.