Effects of Two Different Modes of Task Practice with Upper-Limb Constraint-Induced Movement Therapy in People with Stroke: A Randomized Controlled Trial

Background: Constraint-induced movement therapy is used to improve upper-limb recovery after stroke, but conventional protocols may be difficult to implement because they often require prolonged treatment duration and intensive therapist supervision. Repetition-based dosing may provide a clearer and more practical method for prescribing task-specific CIMT practice. Objective: To compare the effects of duration-based and repetition-based upper-limb CIMT on motor activity, motor function, motor impairment, and upper-limb self-efficacy in people with stroke. Methods: This single-center randomized controlled trial included 70 participants with ischemic or hemorrhagic stroke within four weeks of onset. Participants were randomized into Group A, which received duration-based CIMT, and Group B, which received repetition-based CIMT. Group A performed three hours of shaping practice per day, while Group B completed 300 shaping repetitions per day in three sessions. Outcomes were assessed at baseline, week 2, and week 4 using the Motor Activity Log, Wolf Motor Function Test, Fugl-Meyer Assessment, and Upper Limb Self-Efficacy Test. Non-parametric tests were used because baseline outcome data were not normally distributed. Results: Both groups showed significant within-group improvement across all outcomes over four weeks. Between-group rank analysis favored repetition-based CIMT for Wolf Motor Function Test, Fugl-Meyer Assessment, and Upper Limb Self-Efficacy Test outcomes, with the strongest effects observed for Fugl-Meyer Assessment and Upper Limb Self-Efficacy Test. Conclusion: Repetition-based CIMT produced stronger improvement in upper-limb motor impairment, functional performance, and self-efficacy than duration-based CIMT and may provide a practical alternative for post-stroke upper-limb rehabilitation.