ABSTRACT

Objective : The purpose of this study was to investigate the effect of constraint-induced movement therapy (CIMT) on the affected upper extremity's kinematic changes for persons with stroke using motion analysis.Methods : Eight persons with hemiparesis had participated in CIMT for two weeks. All subjects performed cup shift and pencil shift tasks. For each task, subjects were asked to reach to a cup/or pencil, grasp, move forward, and replace it by releasing. To determine the changes of kinematic parameters by CIMT during the two upper extremity tasks, motion data were collected and analyzed using a 3-D motion analysis system(CMS-HS [Zebris Medizintechnil GmbH, Isny, Germany]). The movement's agility and smoothness, the trace distance's efficiency, the time to maximum velocity arrival, and the numbers of inversion velocity of shoulder, elbow, and wrist joints were compared between pre and post training.Results : First, the time to maximum velocity during reaching and placing of cup at all three joints was significantly decreased from the pre-intervention to the post-intervention(p<.05). However, during the relatively small hand task, pencil shift task, the time to maximum velocity was significantly decreased only at the shoulder joint. Second, during the cup shift task, the inversion velocity in anteroposterior direction was significantly decreased at all joints(p<.05). However, the inversion velocity at shoulder joint was significantly decreased only in horizontal and vertical direction(p<.05). The inversion velocity during the pencil shift task was significantly decreased after the training in all directions at the shoulder and elbow joints, however, there was no significant change in anteroposterior and horizontal direction at wrist joint. Finally, the trace distance's efficiency measured by the variation of the movement trajectory during the cup shift task was significantly decreased at the shoulder and elbow joint(p<.05), and it was significantly decreased at all joints during the pencil shift task(p<.05).Conclusion : The results of this study indicated that CIMT showed improved agility, smoothness, and efficiency of the affected upper extremity. Therefore, this study provides a qualitative evidence of the effectiveness of the CIMT as a useful method to improve the affected upper extremity's motor function.