Constraint-induced movement therapy following stroke: a commentary

Abstract

Over 113000 patients present with stroke each year in the UK, the societal cost of which is approximately £26 billion annually, with £20.6 billion attributed to care after stroke. Approximately 70% of stroke survivors suffer from impaired arm function, with recovery patterns heavily influenced by initial motor weakness. Constraint-induced movement therapy has demonstrated some potential in rehabilitating this dysfunction, when finger extension is preserved. Therefore, constraint-induced movement therapy is now recommended in national healthcare guidelines. Systematic reviews of constraint-induced movement therapy have varied in their sample groups, focusing on acute, subacute and chronic strokes, with varying delivery protocols. A systematic review was undertaken in 2023 with the aim of identifying the efficiency of constraint induced movement therapy in patients with preserved finger extension, as well as the optimum protocol for delivery. This commentary critically appraises the methods used in the review and expands on the findings in the context of clinical practice.