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About the Authors

Meirgul I. Assylbek  - Head of the Rehabilitation Department, Mediker LLP; PhD, Department of Emergency Medicine and Nursing. Department of Emergency Medicine and Nursing, South Kazakhstan Medical Academy, Shymkent, Kazakhstan, This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID: 0000-0003-0338-3281

Seidahmetova Aizat - Head of the Department of Emergency Medicine and Nursing, Dean of the Faculty of Medicine, Associate Professor. Mediker Medical Center, Rehabilitation Department, Shymkent, Kazakhstan, ORCID: 0000-0002-5794-3814.

Saltanat K. Yerkebayeva - Associate Professor, Department of Neurology, Psychiatry, Neurosurgery and Rehabilitation. Department of Neurology, Psychiatry, Neurosurgery and Rehabilitation, South Kazakhstan Medical Academy, Shymkent, Kazakhstan, ORCID: 0009-0003-1234-7044.

Abstract

Background. Constraint-induced movement therapy (CIMT) is an evidence-based rehabilitation approach aimed at improving upper-limb function after stroke. However, the effects of CIMT combined with standard rehabilitation on broader patient-centred outcomes, including quality of life, disability, cognitive function, and emotional status, require further evaluation. This study assessed these outcomes in patients with ischemic stroke.

Aim. This study assessed quality of life, disability, cognitive function, and emotional status in patients with ischemic stroke.

Methods. A prospective comparative non-randomized controlled clinical study was conducted among 396 patients with ischemic stroke involving the middle cerebral artery territory and residual neurological impairment. Following screening of 410 patients, 14 were excluded. Patients were assigned according to the rehabilitation treatment received in routine clinical practice to a CIMT group (n=198) and a standard rehabilitation group (n=198). Both groups received standard rehabilitation for 80 minutes per day for 14 consecutive days. The intervention group additionally received CIMT for 80 minutes per day, resulting in a total scheduled rehabilitation time of 160 minutes per day compared with 80 minutes per day in the control group. Neurological, functional, cognitive, emotional, and health-related quality-of-life outcomes were assessed using the NIHSS, mRS, Barthel Index, MoCA, MMSE, HADS, and SF-36.

Results. The intervention group demonstrated significantly greater improvements in NIHSS (-5.05±1.42 vs -2.38±1.14), mRS (-1.54±0.50 vs -0.56±0.50), and Barthel Index (+31.03±5.74 vs +17.42±4.62) compared with the control group (all p<0.001). Greater improvements were also observed in MoCA (+5.04±1.42 vs +2.47±1.13), MMSE (+3.40±1.17 vs +2.06±0.81), HADS-A (-4.93±1.38 vs -2.60±1.10), and HADS-D (-4.96±1.40 vs -2.56±1.09), all p<0.001. Health-related quality of life showed a greater improvement in the intervention group, with a mean change in SF-36 score of +22.54±4.67 compared with +13.17±3.22 in the control group (p<0.001).

Conclusion. CIMT combined with standard rehabilitation was associated with greater short-term improvements in neurological, functional, cognitive, emotional, and health-related quality-of-life outcomes compared with standard rehabilitation alone. CIMT may be a useful adjunct to standard rehabilitation for selected patients after ischemic stroke. However, the additional rehabilitation time in the CIMT group and non-randomized treatment allocation limit causal interpretation. Randomized controlled studies with longer follow-up are warranted.

Keywords

Constraint-Induced Movement Therapy; Stroke; Rehabilitation; Quality of Life; Cognition; Anxiety; Depression; Disability Evaluation.

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