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Use it or Lose it

Teaching stroke patients to use their stroke-affected arm instead of their "good" arm has become a wide-spread physical therapy (PT) technique.

EXCITE (Extremity Constraint-Induced Therapy Evaluation)—the 2006 study that first proved it to be an effective technique—was selected by the Physiotherapy Evidence Database as one of the top 15 PT trials in the world. The study was led nationally by Steven Wolf, professor of rehabilitation medicine at Emory. Trials were selected for their significant impact in stroke rehabilitation and for setting the stage for many future trials.  

The original trial enrolled 222 patients at seven sites who predominantly had suffered ischemic stroke. Patients had their less-impaired hand or arm restrained with an immobilizing mitt, then took part in behavioral therapy that included tasks such as opening a lock, turning a doorknob, or pouring a drink. Patients were evaluated using the Wolf Motor Function Test (named after Steven Wolf.)

 "Often, stroke rehabilitation focuses on teaching patients how to better rely on their stronger limbs, even if they retain some use in the impaired limbs, creating a learned disuse," says Wolf. "This trial focused on the impaired limb, which proved to be a valuable form of rehabilitation."

Some 28,000 trials and manuscripts, going back as far as 1929, were reviewed for the honor.

Related Resources:

"Constraint-induced therapy for stroke rehabilitation chosen as top trial internationally; Emory expert leads national trial" (Emory News Center, 11/7/15)

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