Effectiveness of modified constraint-induced movement therapy on upper limb function of stroke survivors in inpatient hospital settings: a systematic review and meta-analysis
Creators: name: Hansen, Ricky J.
name: Joy, Anna
name: Lockwood, Kylee J.
Publisher: name: Taylor & Francis
Year: 2025
Subjects: subject: Space Science
subject: Medicine
subject: Physiology
subject: FOS: Biological sciences
subject: Biotechnology
subject: Sociology
subject: FOS: Sociology
subject: Chemical Sciences not elsewhere classified
subject: Science Policy
subject: Biological Sciences not elsewhere classified
subject: Mental Health

description: To synthesise evidence on the effectiveness of modified constraint-induced movement therapy on upper limb function in stroke survivors within inpatient hospital settings. A systematic review was pre-registered in PROSPERO (CRD42023421715b) and searched six databases (EMBASE, AMED, MEDLINE, CINAHL, Cochrane Library, OTseeker) up to November 2024. Articles included adults with stroke undergoing modified constraint-induced movement therapy in inpatient hospital settings. Article quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. Homogenous data was synthesised in a meta-analysis and assessed using the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach. Remaining data was synthesised descriptively. Ten randomised controlled trials (364 participants) were included. Four (191 participants) were analysed in a meta-analysis, showing modified constraint-induced movement therapy improved upper limb function (standardised mean difference (SMD) 0.94, 95% confidence interval (CI) 0.40 to 1.48), based on low-quality evidence. Five articles included follow-up, with two (90 participants) reporting sustained improvements. Five articles assessed activities of daily living, with two (136 participants) reporting positive effects. Modified constraint-induced movement therapy improves upper limb function in the acute and sub-acute stages of stroke recovery within inpatient hospital settings. Sustainability of improvements and the impact on activities of daily living remains uncertain. In the acute and sub-acute stages of stroke, modified constraint-induced movement therapy in inpatient hospital settings is associated with improved upper limb function.Rehabilitation clinicians should routinely consider constraint-induced movement therapy for eligible stroke survivors in inpatient hospital settings.It is uncertain whether improvements in upper limb function leads to improvements in activities of daily living.The sustainability of the benefits of modified constraint-induced movement therapy in inpatient hospital settings is uncertain. In the acute and sub-acute stages of stroke, modified constraint-induced movement therapy in inpatient hospital settings is associated with improved upper limb function. Rehabilitation clinicians should routinely consider constraint-induced movement therapy for eligible stroke survivors in inpatient hospital settings. It is uncertain whether improvements in upper limb function leads to improvements in activities of daily living. The sustainability of the benefits of modified constraint-induced movement therapy in inpatient hospital settings is uncertain.