COMPARATIVE ANALYSIS OF TASK-SPECIFIC TRAINING AND MODIFIED CONSTRAINT-INDUCED MOVEMENT THERAPY ON WRIST AND HAND RANGE OF MOTION AND SPASTICITY AMONG HEMIPLEGIC STROKE PATIENTS

Abstract

Background:

Stroke remains one of the leading causes of long-term disability worldwide, with upper-limb impairment, reduced joint mobility, and spasticity being major barriers to functional independence. Rehabilitation approaches targeting upper-extremity recovery are essential for improving daily living activities among stroke survivors. Task-Specific Training (TST) focuses on purposeful functional activities, whereas Modified Constraint-Induced Movement Therapy (m-CIMT) promotes repetitive use of the affected limb by restricting the unaffected extremity. However, limited evidence exists regarding direct comparison of these interventions specifically for wrist and hand range of motion (ROM) and spasticity outcomes.

Objective:

The present study aimed to compare the effectiveness of Task-Specific Training and Modified Constraint-Induced Movement Therapy on wrist and hand ROM and spasticity among patients with hemiplegic stroke.

Methodology:

A randomized controlled trial was conducted among 66 hemiplegic stroke patients. Participants were randomly allocated into two equal groups (n=33 each). Group A received Task-Specific Training, while Group B received Modified Constraint-Induced Movement Therapy for six weeks. Wrist and hand ROM were assessed using a universal goniometer, while spasticity was evaluated using the Modified Ashworth Scale (MAS). Data were analyzed using ANCOVA with baseline values controlled as covariates.

Results:

The findings demonstrated that m-CIMT produced significantly greater improvements in wrist and hand ROM compared with TST. The adjusted mean wrist flexion ROM was 71.42° in the m-CIMT group compared with 62.88° in the TST group (p<0.001, partial η²=0.548). Similar significant improvements were observed across MCP, PIP, and DIP joint movements. Conversely, TST demonstrated superior reduction in spasticity, with significantly lower adjusted MAS scores for wrist, finger, and thumb movements compared with m-CIMT (p<0.001).

Conclusion:

Both rehabilitation approaches were effective in improving upper-limb recovery after stroke; however, their therapeutic benefits differed. m-CIMT demonstrated greater effectiveness for improving wrist and hand mobility, whereas TST was more beneficial for reducing spasticity. Selection of intervention should therefore depend on the primary rehabilitation objective.