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BACKGROUND Data from monkeys with deafferented forelimbs and humans after stroke indicate that tests of the motor capacity of impaired extremities can overestimate their spontaneous use. Before the Motor Activity Log (MAL) was developed, no instruments assessed spontaneous use of a hemiparetic arm outside the treatment setting. OBJECTIVE To study the(More)
A new family of rehabilitation techniques, termed Constraint-Induced Movement Therapy or CI Therapy, has been developed that controlled experiments have shown is effective in producing large improvements in limb use in the real-world environment after cerebrovascular accident (CVA). The signature therapy involves constraining movements of the less-affected(More)
Research on monkeys with a single forelimb from which sensation is surgically abolished demonstrates that such animals do not use their deafferented limb even though they possess sufficient motor innervation to do so, a phenomenon labeled learned nonuse. This dissociation also occurs after neurological injury in humans. Instruments that measure these two(More)
CONTEXT Single-site studies suggest that a 2-week program of constraint-induced movement therapy (CIMT) for patients more than 1 year after stroke who maintain some hand and wrist movement can improve upper extremity function that persists for at least 1 year. OBJECTIVE To compare the effects of a 2-week multisite program of CIMT vs usual and customary(More)
BACKGROUND AND PURPOSE Constraint-Induced Movement therapy (CI therapy) is a neurorehabilitation technique developed to improve use of the more affected upper extremity after stroke. A number of studies have reported positive effects for this intervention, but an experiment with a credible placebo control group has not yet been published. METHODS We(More)
BACKGROUND AND PURPOSE Studies on adult stroke patients have demonstrated functional changes in cortical excitability, metabolic rate, or blood flow after motor therapy, measures that can fluctuate rapidly over time. This study evaluated whether evidence could also be found for structural brain changes during an efficacious rehabilitation program. METHODS(More)
BACKGROUND AND PURPOSE The consensus is that the most important outcome for rehabilitation is functional activity in the life situation. Constraint-Induced Movement Therapy, a new treatment that transfers in-clinic gains to the life situation, demands objective measurement of real-world movement. However, direct, objective, and accurate measures of arm use(More)
This article describes the study design, methodological considerations, and demographic characteristics of a phase III RCT to determine if 1) constraint-induced therapy (CI therapy) can be applied with therapeutic success 3 to 9 months after stroke across different sites, 2) gains that might occur persist over 2 years, 3) initial level of motor ability(More)
OBJECTIVE To examine the reliability of the Wolf Motor Function Test (WMFT) for assessing upper extremity motor function in adults with hemiplegia. DESIGN Interrater and test-retest reliability. SETTING A clinical research laboratory at a university medical center. PATIENTS A sample of convenience of 24 subjects with chronic hemiplegia (onset >1yr),(More)
OBJECTIVE To evaluate the reliability and validity of accelerometry for measuring upper-extremity rehabilitation outcome. DESIGN Validation study. SETTING Data recorded in the community. PARTICIPANTS Consecutive Constraint-Induced Movement therapy (CIMT) patients (n = 10) and volunteer community residents with stroke (n = 10). All participants were(More)