Improving Stroke Recovery-The EXCITE Trial

November 9, 2006

The EXCITE trial was the lead article in last week’s JAMA. It looks at a 2 week program of contstraint induced movement therapy vs. usual care in patients suffering a cva within the previous 3-9 months. Pt’s in the treatment arm wore a restraining mitt on the less-affected hand and engaged in tasks/behaviors with the hemiplegic hand. This group was compared to a control group with usual care. Measures of performance time and motor function ability all showed clinically relevant improvements that persisted out to 1 year.

Commentary By Rob Staudinger, M.D. Program Director, NYU Neurology Residency, Associate Chief of Neurology at the Veterans Affairs NYHHS.

Stroke is the leading cause of disability in the US. Currently used rehabilitation treatments generally are based on empirical approaches rather than validated therapies. The EXCITE (Extremity Constraint Induced Therapy Evaluation) trial is interesting in several ways. It is the first multisite randomized study to demonstrate the efficacy of a rehabilitative intervention. It included patients who had the first stroke in the previous 3-9 months and therefore suggests that more recovery after a stroke is possible than we currently teach. The study included only patients with limited disability and it remains to be seen if this approach, based on the concept of neuronal plasticity, holds promise for more severely affected patients.

Wolf SL, et al “Effect of Constraint-Induced Movement Therapy on Upper Extremity Function 3 to 9 Months After Stroke: The EXCITE Randomized Clinical Trial” JAMA 2006; 296 (17): 2095-2104.

One Response to Improving Stroke Recovery-The EXCITE Trial

  1. Raquel on October 4, 2007 at 11:47 pm

    Hello, my name is Raquel M. Jacovani and I am an Occupational Therapy Assistant Student.
    I was reading through your website regarding the CIMT program and I found it Awesome,very interesting.

    I am on my level II fieldwork in a Rehab Hospital in CA and I will do an In Service about CIMT for stroke patients. I found a lot of others website, but your website got my attention, so I decided to email you to know more about it! Can you please answer those questions ASAP?

    How and where can the therapists be training on CIMT?

    Do you have or know of any media material that I can use in my in Service presentation? I need something visual i.e. Video

    What is the possibility of having someone to come and present the program to the hospital?

    What are the Pros-and Cons of CIMT?

    Thank you so much!

    And I look forward to hearing from you as soon as possible

    Raquel

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