• Van Delden et al did an interesting study looking at three different versions of post-stroke motor rehabilitation therapies for arm paresis: unilateral (modified constraint induced movement therapy), bilateral (modified bilateral arm training with rhythmic auditory cueing) and dose-matched conventional treatment.

    They randomized 60 patients who were 1-6 months after their stroke into the three treatment arms treated for six weeks for 3 hours a week (60minute sessions, 3 times a week) and encouraged to do exercises at home. The results showed no demonstrably different outcomes in arm paresis after the intervention period using a standardized assessment tool Action Research Arm Test (ARAT).

    While much has said about constraint induced movement therapy, few randomized studies have sought out to answer this specific question. I’m glad to see there is work in the stroke rehab community to evaluate the effectiveness of certain therapies compared with others. For now, I will still recommend my patients to seek as much rehab and exercise as they will tolerate, as only maximal effort and maximal time has demonstrated results.