Determining the Effects of Modified Constraint-Induced Movement Therapy on Motor Functioning in Hemiplegic Upper Extremity Among Patients After Stroke: Randomized Controlled Trial

Abstract

Background: Stroke-related hemiplegia commonly impairs upper-extremity motor function and restricts independence in daily activities. Although constraint-induced movement therapy (CIMT) promotes affected-limb use, trunk restraint may further reduce compensatory movements and enhance motor recovery. Objective: To compare the effects of modified constraint-induced movement therapy (mCIMT) combined with trunk restraint versus conventional physiotherapy on upper-extremity motor function in patients with post-stroke hemiplegia. Methodology: This parallel-group, single-blind randomized controlled trial was conducted over 9 months at Lahore General Hospital and the University Physical Therapy and Rehabilitation Clinic, University of Lahore. Sixty patients with post-stroke hemiplegia were randomized to mCIMT with trunk restraint (n=30) or conventional physiotherapy (n=30). The intervention group received 1-hour sessions, 5 days/week for 4 weeks, using a padded mitt and trunk restraint. The control group received conventional physiotherapy at the same frequency. Upper-extremity motor function was assessed using the Motor Assessment Scale at baseline, week 4, and week 8 by a blinded assessor. Results: Both groups showed progressive improvement in MAS scores. The mCIMT with trunk restraint group increased from 10.77±2.30 at baseline to 22.30±2.42 at week 4 and 46.67±3.94 at week 8, while the conventional physiotherapy group increased from 7.23±2.74 to 15.53±2.89 and 23.57±2.19, respectively. Conclusion: mCIMT with trunk restraint significantly improved upper-extremity motor function compared with conventional physiotherapy, supporting its targeted use in post-stroke rehabilitation while warranting further evaluation of sustained effects.