Ont Health Technol Assess Ser. 2011;11(6):1-58. Epub 2011 Nov 01.
Ontario health technology assessment series
[No authors listed]
PMID: 23074418 PMCID: PMC3377570
PRIMARY OUTCOME: ARM MOTOR FUNCTION: Action Research Arm Test (ARAT) SECONDARY OUTCOME: ARM MOTOR IMPAIRMENT: Fugl-Meyer Motor Assessment (FMA)ACTIVITIES OF DAILY LIVING (ADL): Functional Independence Measure (FIM), Chedoke Arm and Hand InventoryPERCEIVED MOTOR FUNCTION: Motor Activity Log (MAL) Amount of Use (AOU) and Quality of Movement (QOM) scales
QUALITY OF LIFE: Stroke Impact Scale (SIS) SUMMARY OF FINDINGS: A significant difference was found in our primary outcome of arm motor function measured with the Action Research Arm Test in favour of CIMT compared with usual care delivered with the same intensity and duration. Significant differences were also found in three of the five secondary outcome measures including Arm Motor Impairment and Perceived Motor Function Amount of Use and Quality of Use. There was a nonsignificant effect found with the FIM score and the quality of life Stroke Impact Scale outcome measure. The nonsignificant effect found with the scale score and the quality of life score may be a factor of a nonresponsive outcome measure (FIM scale) and/or a type II statistical error from an inadequate sample size. The quality of evidence was moderate for arm motor function and low for all other outcome measures except quality of life, which was very low. Table 1:Summary of Results(*)OutcomeOutcome MeasureNumber of Studies (n)Mean Difference in Change scores CIMT vs. Usual Care [95% C.I.]ResultsGRADE Quality of EvidenceArm motor functionAction Research Arm Test4(43)13.6[8.7, 18.6]SignificantModerateArm motor impairmentFugl-Meyer Motor Assessment8(169)6.5[2.3, 10.7]SignificantLowActivities of daily livingFunctional Independence Measure4(128)3.6[-0.22, 7.4]NonsignificantLowSelf-reported amount of arm usePerceived Arm Motor Function (Amount of Use) Scale8(241)1.1[0.60, 1.7]SignificantLowSelf-reported quality of arm usePerceived Arm Motor Function (Quality of Use) Scale8(241)0.97[0.7, 1.3]SignificantLowQuality of lifeStroke Impact Scale2(66)3.9[-5.6, 13.5]NonsignificantVery Low*CI, Confidence Intervals; n, Sample Size.