Effects of lower extremity constraint-induced movement therapy on gait and balance of chronic hemiparetic patients after stroke: description of a study protocol for a randomized controlled clinical trial.

Protocols involving intensive practice have shown positive outcomes. Constraint induced movement therapy (CIT) appears to be one of the best options for better outcomes in upper limb rehabilitation, but we still have little data about lower extremity constraint-induced movement therapy (LE-CIT) and its effects on gait and balance. To evaluate the effects of an LE-CIT protocol on gait functionality and balance in chronic hemiparetic patients following a stroke. The study adopts a randomized, controlled, single-blinded study design. Forty-two patients, who suffered a stroke, who were in the chronic phase of recovery (>6 months), with gait disability (no community gait), and who were able to walk at least 10 m with or without the advice or support of 1 person, will be randomly allocated to 2 groups: the LE-CIT group or the control group (intensive conventional therapy). People will be excluded if they have speech deficits that render them unable to understand and/or answer properly to evaluation scales and exercises selected for the protocol and/or if they have suffered any clinical event between the screening and the beginning of the protocol. Outcome will be assessed at baseline (T0), immediately after the intervention (T1), and after 6 months (T2). The outcome measures chosen for this trial are as follows: 6-min walk test (6minWT), 10-m walk test (10mWT), timed up and go (TUG), 3-D gait analysis (3DGA), Mini Balance Evaluation Systems Test (Mini-BESTest), and as a secondary measure, Lower Extremity Motor Activity Log will be evaluated (LE-MAL). The participants in both groups will receive 15 consecutive days of daily exercise. The participants in the LE-CIT group will be submitted to this protocol 2.5 h/day for 15 consecutive days. It will include (1) intensive supervised training, (2) use of shaping as strategy for motor training, and (3) application of a transfer package (plus 30 min). The control group will receive conventional physiotherapy for 2.5 h/day over 15 consecutive days (the same period as the CIT intervention). Repeated measures analyses will be made to compare differences and define clinically relevant changes between groups. Data collection is currently on-going and results are expected in 2021. LE-CIT seems to be a good protocol for inclusion into stroke survivors' rehabilitation as it has all the components needed for positive results, as well as intensity and transference of gains to daily life activities. www.ensaiosclinicos.gov.br RBR-467cv6 . Registered on 10 October 2017. "Effects of Lower Extremities - Constraint Induced Therapy on gait and balance function in chronic hemipretic post-stroke patients".

Menezes-Oliveira E ，da Silva Matuti G ，de Oliveira CB ，de Freitas SF ，Kawamura CM ，Lopes JAF ，Arida RM ... -  《Trials》

Improvement of gait and balance function in chronic post-stroke patients induced by Lower Extremity - Constraint Induced Movement Therapy: a randomized controlled clinical trial.

Menezes-Oliveira E ，da Silva Matuti G ，de Oliveira CB ，de Freitas SF ，Miyuki Kawamura C ，Fernandes Lopes JA ，Faber J ，Arida RM ... -  《-》

Constraint-induced movement therapy for lower extremity use in activities of daily living in people with chronic hemiparesis: multiple case study.

Lower extremity constraint-induced movement therapy (LE-CIMT) is an intensive intervention protocol recently reported to improve lower extremity use in individuals with chronic hemiparesis. To test if the LE-CIMT that uses essential CIMT components, including the transfer package and intensive task-oriented training, is a feasible and potentially effective intervention to improve the lower extremity real-world use and functional ability in a group of individuals with chronic hemiparesis. A quasi-experimental pre- and post-test design study with 12 individuals with chronic stroke and impaired ambulation skills engaged in a 10-weekday LE-CIMT. Intervention feasibility was assessed, examining the training adherence, acceptability, and safety. The lower extremity motor activity log (LE-MAL), lower extremity motor function test (LE-MFT), timed up and go (TUG) and spatiotemporal gait parameters were used as clinical outcomes. Clinical data were collected at baseline, 3-day post-CIMT protocol and 30-day follow-up assessment. At baseline, LE-MAL and LE-MFT outcomes were tested over 2-week apart to ensure a stable measurement and determine the smallest real difference (SRD) in the study sample. The LE-CIMT showed excellent adherence, acceptability and safety. Ten out of 12 participants showed improvements over SRD in LE-MAL composite score (1.2 point) and eight participants in LE-MFT adjusted scores (0.8 point) in post-CIMT and 30-day follow-ups. LE-CIMT is a feasible intervention that has the potential to promote improvements in real-world use and functional ability of the paretic lower extremity in individuals with chronic stroke.

Duarte Pereira N ，Ilha J ，Dos Anjos SM ，Morris D ... -  《-》

A combination of multimodal physical exercises in real and virtual environments for individuals after chronic stroke: study protocol for a randomized controlled trial.

Mazzini NA ，Almeida MGR ，Pompeu JE ，Polese JC ，Torriani-Pasin C ... -  《Trials》

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

Marklund I ，Sefastsson A ，Fure B ，Klässbo M ，Liv P ，Stålnacke BM ，Hu X ... -  《-》