Effects of Two Different Modes of Task Practice with Upper-Limb Constraint-Induced Movement Therapy in People with Stroke: A Randomized Controlled Trial

Muhammad Noman Tasawer; Zunaira Mehdi; Hafiza Sana Ashraf; Misbah Tariq; Syeda Tayyaba Saeed; Sarah Irshad

doi:10.61919/r0bbda07

Authors

Muhammad Noman Tasawer College of Allied Health Sciences, Bakhtawar Amin Medical College, Multan, Pakistan Author
Zunaira Mehdi College of Allied Health Sciences, Bakhtawar Amin Medical College, Multan, Pakistan Author
Hafiza Sana Ashraf University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan Author
Misbah Tariq College of Allied Health Sciences, Bakhtawar Amin Medical College, Multan, Pakistan Author
Syeda Tayyaba Saeed College of Allied Health Sciences, Bakhtawar Amin Medical College, Multan, Pakistan Author
Sarah Irshad College of Allied Health Sciences, Bakhtawar Amin Medical College, Multan, Pakistan Author

DOI:

https://doi.org/10.61919/r0bbda07

Keywords:

Constraint-induced movement therapy, stroke rehabilitation, upper limb, task practice, motor function, Fugl-Meyer Assessment, self-efficacy.

Abstract

Background: Constraint-induced movement therapy is used to improve upper-limb recovery after stroke, but conventional protocols may be difficult to implement because they often require prolonged treatment duration and intensive therapist supervision. Repetition-based dosing may provide a clearer and more practical method for prescribing task-specific CIMT practice. Objective: To compare the effects of duration-based and repetition-based upper-limb CIMT on motor activity, motor function, motor impairment, and upper-limb self-efficacy in people with stroke. Methods: This single-center randomized controlled trial included 70 participants with ischemic or hemorrhagic stroke within four weeks of onset. Participants were randomized into Group A, which received duration-based CIMT, and Group B, which received repetition-based CIMT. Group A performed three hours of shaping practice per day, while Group B completed 300 shaping repetitions per day in three sessions. Outcomes were assessed at baseline, week 2, and week 4 using the Motor Activity Log, Wolf Motor Function Test, Fugl-Meyer Assessment, and Upper Limb Self-Efficacy Test. Non-parametric tests were used because baseline outcome data were not normally distributed. Results: Both groups showed significant within-group improvement across all outcomes over four weeks. Between-group rank analysis favored repetition-based CIMT for Wolf Motor Function Test, Fugl-Meyer Assessment, and Upper Limb Self-Efficacy Test outcomes, with the strongest effects observed for Fugl-Meyer Assessment and Upper Limb Self-Efficacy Test. Conclusion: Repetition-based CIMT produced stronger improvement in upper-limb motor impairment, functional performance, and self-efficacy than duration-based CIMT and may provide a practical alternative for post-stroke upper-limb rehabilitation.

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