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Modified constraint-induced therapy combined with mental practice : thinking through better motor outcomes . BACKGROUND AND PURPOSE Modified constraint-induced therapy ( mCIT ) is an outpatient therapy encouraging repetitive , task-specific practice with the affected arm . mCIT has shown efficacy in all stages poststroke . Given its efficacy when combined with other therapy regimens , the current study examined the efficacy of mental practice when combined with mCIT versus mCIT only using randomized , controlled methods . METHOD Ten patients with chronic stroke ( 7 males ; mean age , 61.4+/-3.02 years ; age range , 48 to 79 years ; mean time since stroke , 28.5 months ; range , 13 to 42 months ) exhibiting stable , affected arm motor deficits were administered mCIT , consisting of : ( 1 ) structured therapy emphasizing affected arm use in functional activities 3 days/week for 10 weeks ; and ( 2 ) less affected arm restraint 5 days/week for 5 hours . Both of these components were administered during a 10-week period . Subjects randomly assigned to the mCIT+mental practice experimental condition also received 30-minute mental practice sessions provided directly after therapy sessions . These mental practice sessions required daily cognitive rehearsal of the activities of daily living practiced during mCIT clinical sessions . RESULTS No pre-existing differences were found between groups on any demographic variable or movement scale . All subjects exhibited marked reductions in affected arm impairment and functional limitation . However , subjects in the mCIT+mental practice group exhibited significantly larger changes on both movement measures after intervention : Action Research Arm Test , +15.4-point change versus +8.4-point change for mCIT only subjects ( P < 0.001 ) ; Fugl-Meyer , +7.8-point change versus +4.1-point change for the mCIT only subjects ( P=0.01 ) . These changes were sustained 3 months after intervention . CONCLUSIONS mCIT remains a promising motor intervention . However , its efficacy appears to be enhanced by use of mental practice provided directly after mCIT clinical sessions .
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Intervention_Physical
Modified constraint-induced therapy
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Intervention_Educational
mental practice :
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Intervention_Other
Modified constraint-induced therapy ( mCIT )
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Intervention_Physical
mCIT
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Intervention_Educational
mental practice
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Intervention_Physical
mCIT
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Intervention_Physical
mCIT only
38403
Intervention_Physical
mCIT
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Intervention_Educational
mCIT+mental practice
38405
Intervention_Educational
mental practice
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Intervention_Physical
mCIT
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Intervention_Physical
mCIT+mental practice
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Intervention_Physical
mCIT only
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Intervention_Physical
mCIT only
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Intervention_Physical
mCIT
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Intervention_Educational
mental practice
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Intervention_Physical
mCIT
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Outcome_Physical
affected arm impairment and functional limitation .
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Outcome_Physical
movement measures