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  • Title: Does the use of a constraint mitten to encourage use of the hemiplegic upper limb improve arm function in adults with subacute stroke?
    Author: Burns A, Burridge J, Pickering R.
    Journal: Clin Rehabil; 2007 Oct; 21(10):895-904. PubMed ID: 17981848.
    Abstract:
    OBJECTIVE: To evaluate the effect of a constraint mitten, worn on the unaffected upper limb, on the arm and hand function of participants with hemiplegia. To estimate the sample size for a future trial. DESIGN: An A-B-A design. SETTING: Inpatient, outpatient and domiciliary setting. SUBJECTS: Ten participants with mild to moderate residual upper limb hemiparesis, between 1 and 12 months post stroke. INTERVENTION: Following a two-week baseline period, 10 participants were advised to wear the constraint mitten on the unaffected upper limb for 9 waking hours/day for two weeks to encourage use of the hemiplegic arm. Existing levels of therapy continued during the whole study. MAIN MEASURES: The primary outcome measure was the Action Research Arm Test. At the end of the intervention phase participants completed a questionnaire. Participants also recorded their daily use of the constraint mitten during the intervention phase. RESULTS: A mean improvement in the Action Research Arm Test score of 4.0 points (95% confidence interval 1.7 to 6.2; P=00.016) was found during the intervention phase after correcting for background recovery. Mean compliance was 6.7 hours/day (74%), 90% of participants were positive about the intervention and would recommend the treatment to other stroke survivors, although 50% were relieved to stop the mitten-wearing phase. CONCLUSIONS: The use of a constraint mitten in upper limb stroke rehabilitation may be a useful adjunct to enhance functional recovery with minimal additional resources. The positive findings from this preliminary study warrant a larger randomized controlled trial of 200 participants in total.
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