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Evidence to Improve Care

Constraint-Induced Movement Therapy for Rehabilitation of Arm Dysfunction After Stroke in Adults

Ontario Health Technology Advisory Committee Recommendations

  • Constraint-induced movement therapy shows short-term effectiveness on arm function and should be considered in the stroke rehabilitation regimen beginning no earlier than one month after the onset of stroke.

  • Contextualization of these findings in terms of the management of stroke rehabilitation in Ontario is required.

Read the full OHTAC Recommendation Report

A stroke is a sudden loss of brain function caused by the interruption of blood flow in the brain. Stroke is the leading cause of neurological disability in adults in Canada.

Up to 85% of people who have had a stroke are left with reduced function in one of their arms. Rehabilitation therapy is an important part of care after a stroke and helps patients recover as much function as possible.

Health Quality Ontario Reviews Constraint-Induced Movement Therapy

Constraint-induced movement therapy is a rehabilitation method designed to improve arm function after stroke. In this therapy, the healthy arm is restrained in a sling for most of the day and the damaged arm is exercised intensively and repeatedly over many days. Not being able to use their “good” arm prevents patients from giving up on the use of the affected arm and allows them to experience gradual, encouraging improvements in their arm function.

Constraint-Induced Movement Therapy for Rehabilitation of Arm Dysfunction After Stroke in Adults: An Evidence-Based Analysis (PDF)
November 2011

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The Ministry of Health and Long-Term Care has accepted this recommendation.

The Ministry of Health and Long-Term Care has provided the following response: The Ministry has added this recommendation to the stroke care clinical handbook which is a funded quality-based procedure.

Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.


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