Electromyographic analysis of constraint-induced movement therapy effects in patients after stroke in chronic course.
Mariéle Marchezan Zarantonello, Marco Antonio Stefani, João Carlos Comel
PMID 29200616WHAT IT FOUND
After 10 days of constraint-induced movement therapy, 5 chronic-stroke patients showed lower resting biceps electrical activity and higher contraction activity except in case V.
Reported arm use, quality, task speed, and independence improved. Only before-and-after results were reported, so the therapy alone cannot be credited.
Key findings
01Resting biceps EMG signals decreased after CIMT in 5 patients.
02Biceps contraction EMG signals increased after CIMT except in case V.
03Motor Activity Log amount-of-movement mean improved from 0.45 to 2.8 and quality-of-movement from 0.40 to 2.3; Wolf Motor Function Test time reduced by mean 4.62 sec ± 3.27.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 5 patients were studied, and the paper itself calls the small sample a limitation. The paper reports only before-and-after results, so improvement after CIMT cannot be separated from time, selection, or other therapy. Patients already attended physical therapy, and the paper does not state whether usual therapy continued, so the effect of CIMT alone cannot be isolated. Surface EMG was limited to the biceps, and the paper notes surface EMG fails to detect deep or small muscles. The Motor Activity Log was self-scored by patients, and the Modified Ashworth Scale is described as ordinal and possibly not sensitive enough for spasticity changes.
The easy way to misread this
Do not conclude that constraint-induced movement therapy caused reduced spasticity or better arm function. Only 5 patients were measured before and after, and they already attended physical therapy, so the changes cannot be separated from other factors.