What drives improvements by CIMT Who

The underlying mechanisms that drive improvement by CIMT are still poorly understood. First, we expected that intensity of task-specific practices (expressed as treatment contrasts [refers to the total time spent on exercise therapy for the experimental group minus that for the control group] in terms of duration) would be a substantial moderator of CIMT. However, our meta-analysis showed no evidence that the type of CIMT or treatment contrast—which amounted to a mean of 47 h difference in treatment times between groups within a trial—had an effect. The absence of effects of treatment BMY 45778 between trials does not imply that dosing of CIMT therapy is not important. However, patients in CIMT trials practice every day at a greater intensity than that usually applied in stroke rehabilitation. Additionally, in a retrospective analysis of 169 participants, Wolf and colleagues83 showed heterozygous the intensity of supervised original CIMT was modified by the amount of repetitive task practice, and to some extent by the initial severity of motor impairment recorded on the Wolf motor function test (WMFT). This finding suggests that the effects of the therapy dose are confounded by the initial severity of neurological deficits. Possible risks of bias, such as blinding of assessors, did not seem to affect the difference between dose-matched trials and non-dose matched trials. These findings accord with those of a trial82 and a meta-analysis84 showing that dose-matched mCIMT, compared with a control group that received an equal dose of bilateral arm training, did not produce significant differences in overall effect sizes.