Effect of Constraint-Induced Movement Therapy (CIMT) on Upper Extremity Function in Stroke Patients

Main Article Content

Kiran Bashir
Alina Noreen
Mehreen Arshad
Amna Tariq
Anees Arshad


Background: Stroke is a leading cause of disability worldwide, with upper extremity impairments presenting significant rehabilitation challenges. Constraint-Induced Movement Therapy (CIMT) has emerged as a potential intervention for enhancing upper limb functionality, but its efficacy compared to traditional therapy methods requires further exploration.

Objective: The study aimed to evaluate the effectiveness of CIMT versus traditional therapy in improving upper extremity function among stroke survivors.

Methods: In this quasi-experimental study, 58 stroke patients from Aziz Fatima and Allied Hospital in Faisalabad were recruited and allocated to either the CIMT group (n=29) or the traditional therapy group (n=29). Eligible participants were those aged 30-50 years with ischemic or infarctive stroke and impaired use of their hemiparetic arm. The CIMT group received standard treatment plus CIMT, while the traditional group received only standard treatment, including manual therapy and TENS, for 8 weeks. Pre- and post-treatment assessments utilized the Upper Extremity Motor Activity Log (UEMAL) scales. Data analysis was conducted using SPSS version 25, employing independent t-tests.

Results: The CIMT group showed a significant improvement in the UEMAL Amount Scale (pre-treatment: 1.64 ± 0.51, post-treatment: 3.04 ± 0.75; p=0.000) and the UEMAL How Well Scale (pre-treatment: 2.28 ± 0.57, post-treatment: 3.81 ± 0.55; p=0.000). The traditional therapy group also demonstrated gains but to a lesser extent (UEMAL Amount Scale pre-treatment: 1.08 ± 0.24, post-treatment: 1.69 ± 0.33; UEMAL How Well Scale pre-treatment: 1.47 ± 0.30, post-treatment: 2.11 ± 0.40; p=0.000 for both).

Conclusion: CIMT provided significant functional improvements in upper extremity motor activity compared to traditional therapy, suggesting that CIMT may be a more effective approach for post-stroke rehabilitation of the upper limb.

Article Details

How to Cite
Bashir, K., Noreen, A., Arshad, M., Tariq, A., & Arshad, A. (2024). Effect of Constraint-Induced Movement Therapy (CIMT) on Upper Extremity Function in Stroke Patients. Journal of Health and Rehabilitation Research, 4(1), 1661–1665. https://doi.org/10.61919/jhrr.v4i1.670
Author Biographies

Kiran Bashir, Margalla Institute of Health Sciences Rawalpindi Pakistan.

Senior Lecturer, Islamabad College of Physiotherapy, Margalla Institute of Health Sciences,  Rawalpindi, Pakistan.

Alina Noreen, University of Sargodha Women Campus Faisalabad Pakistan.

Physical Therapist, University of Sargodha, Women Campus Faisalabad, Pakistan.

Mehreen Arshad, University of Sargodha Women Campus Faisalabad Pakistan.

Physical Therapist, University of Sargodha, Women Campus Faisalabad, Pakistan.

Amna Tariq, University of Sargodha Women Campus Faisalabad Pakistan.

Physical Therapist, University of Sargodha, Women Campus Faisalabad, Pakistan.

Anees Arshad, Margalla Institute of Health Sciences Rawalpindi Pakistan.

Demonstrator, Islamabad College of Physiotherapy, Margalla Institute of Health Sciences, Rawalpindi, Pakistan.


Chen Y, Wright N, Guo Y, Turnbull I, Kartsonaki C, Yang L, et al. Mortality and recurrent vascular events after first incident stroke: a 9-year community-based study of 0· 5 million Chinese adults. The Lancet Global Health. 2020;8(4):e580-e90.

Khan M, Sana FA, Ali Y. Strokes Outcome Determinants in Pakistan Primary Stroke Center. Annals of the Romanian Society for Cell Biology. 2022;26(01):2015-24.

Malik AN, Tariq H, Afridi A, Azam Rathore F. Technological advancements in stroke rehabilitation. Journal of Pakistan Medical Association. 2022;72(8):1672-4.

Ekker MS, Verhoeven JI, Vaartjes I, van Nieuwenhuizen KM, Klijn CJ, de Leeuw F-E. Stroke incidence in young adults according to age, subtype, sex, and time trends. Neurology. 2019;92(21):e2444-e54.

Prestgaard E, Mariampillai J, Engeseth K, Erikssen J, Bodegård J, Liestøl K, et al. Change in body weight and long-term risk of stroke and death in healthy men. Stroke. 2020;51(5):1435-41.

Skajaa N, Adelborg K, Horváth-Puhó E, Rothman KJ, Henderson VW, Casper Thygesen L, et al. Nationwide trends in incidence and mortality of stroke among younger and older adults in Denmark. Neurology. 2021;96(13):e1711-e23.

Watkins K. What does upscaling stroke rehabilitation mean globally? A qualitative description of international variation in stroke rehabilitation and the influences on evidence-based practice: University of Otago; 2020.

Momsen A-MH, Fox JC, Nielsen CV, Thuesen J, Maribo T. Rehabilitation research in Denmark between 2001 and 2020: a scoping review. Frontiers in Rehabilitation Sciences. 2022;3:849216.

Tedla JS, Gular K, Reddy RS, de Sá Ferreira A, Rodrigues EC, Kakaraparthi VN, et al., editors. Effectiveness of constraint-induced movement therapy (CIMT) on balance and functional mobility in the stroke population: a systematic review and meta-analysis. Healthcare; 2022: MDPI.

Hussain M, Fatima A, Ahmad A, Gilani SA. Effects of task oriented rehabilitation of upper extremity after stroke: A systematic review. J Pak Med Assoc. 2022;72:1406-15.

Nesin SM, Sabitha K, Gupta A, Laxmi T. Constraint induced movement therapy as a rehabilitative strategy for ischemic stroke—Linking neural plasticity with restoration of skilled movements. Journal of Stroke and Cerebrovascular Diseases. 2019;28(6):1640-53.

Doumas I, Everard G, Dehem S, Lejeune T. Serious games for upper limb rehabilitation after stroke: a meta-analysis. Journal of neuroengineering and rehabilitation. 2021;18:1-16.

Abba M, Muhammad A, Badaru U, Abdullahi A. Comparative effect of constraint-induced movement therapy and proprioceptive neuromuscular facilitation on upper limb function of chronic stroke survivors. Physiotherapy Quarterly. 2020;28(1):1-5.

Abdullahi A, Truijen S, Saeys W. Neurobiology of recovery of motor function after stroke: the central nervous system biomarker effects of constraint-induced movement therapy. Neural Plasticity. 2020;2020.

Boake C, Noser EA, Ro T, Baraniuk S, Gaber M, Johnson R, et al. Constraint-induced movement therapy during early stroke rehabilitation. Neurorehabilitation and neural repair. 2007;21(1):14-24.

Taub E, McCulloch K, Uswatte G, Morris DM, Bowman M, Crago J. Motor activity log (mal) manual. UAB training for CI therapy. 2011;1:18.

Wang T-N, Liang K-J, Liu Y-C, Shieh J-Y, Chen H-L. Effects of Intensive Versus Distributed Constraint-Induced Movement Therapy for Children With Unilateral Cerebral Palsy: A Quasi-Randomized Trial. Neurorehabilitation and Neural Repair. 2023;37(2-3):109-18.

Alaca N, Öcal NM. Proprioceptive based training or modified constraint-induced movement therapy on upper extremity motor functions in chronic stroke patients: a randomized controlled study. NeuroRehabilitation. 2022;51(2):271-82.

de Azevedo JA, Barbosa FDS, Seixas VM, da Silva Scipioni KRD, Sampaio PYS, da Cruz DMC, et al. Effects of constraint-induced movement therapy on activity and participation after a stroke: Systematic review and meta-analysis. Frontiers in Human Neuroscience. 2022;16:987061.

Marklund I, Sefastsson A, Brynjar F, Klässbo M, Per L, Stålnacke B-M, et al. Lower-extremity constraint-induced movement therapy improved motor function, mobility, and walking after stroke. European journal of physical and rehabilitation medicine. 2023;59(2):136.

Zulu O, Lupenga J, Simpamba MM, Banda MC. Efficacy of Constraint Induced Movement Therapy and Mirror Therapy in Improving Upper Extremity Function in Late Subacute and Chronic Stroke Patients: A randomized crossover trial. Journal of Preventive and Rehabilitative Medicine. 2023;5(2):136-45.