Lower-extremity constraint-induced movement therapy improved motor function, mobility, and walking after stroke.

The study had no control group, so gains could be explained by factors other than the intervention. The physiotherapist who delivered the treatment also performed the assessments, which can bias results. Participants also received individual home-training programs after the clinic intervention. Adherence was not reported, so the contribution of any single component cannot be separated. Forty of 147 participants did not complete the 3-month follow-up, although they did not differ significantly from completers. The sample was relatively young, with a mean age of 51 years, and 68% were men. The authors caution against generalizing to the entire stroke population. All participants could walk indoors without aids before the study. It says little about patients who could not. The lower-extremity FMA was incomplete because reflex and coordination items were excluded. This limits comparison with the smallest change likely to be real. The authors describe a floor effect for Timed Up and Go, so the 8-second smallest change likely to be real was unlikely to be reached. The significance of group treatments was not evaluated.

Do not read the before and after gains as proof that lower-extremity constraint-induced movement therapy alone caused them. The study had no control group, participants also received home training after the clinic intervention, and the treating physiotherapist performed the assessments.