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Protocol for a Randomized Controlled Trial of CI Therapy for Rehabilitation of Upper Extremity Motor Deficit: The Bringing Rehabilitation to American Veterans Everywhere Project. | LitMetric

Protocol for a Randomized Controlled Trial of CI Therapy for Rehabilitation of Upper Extremity Motor Deficit: The Bringing Rehabilitation to American Veterans Everywhere Project.

J Head Trauma Rehabil

From the Departments of Psychology (Drs Taub, Mark, and Uswatte, Mss Bishop-McKay, Taylor, Reder, and Adams, and Mr Womble), Physical Therapy (Drs Morris and Uswatte), Physical Medicine and Rehabilitation (Dr Mark), Neurology (Drs Mark and Szaflarski), Occupational Therapy (Dr Rimmer), and UAB/Lakeshore Research Collaborative (Dr Rimmer and Mr Dew), University of Alabama at Birmingham; Edward Via College of Osteopathic Medicine, Auburn, Alabama (Dr Liu); National Intrepid Center of Excellence, Bethesda, Maryland (Dr Pickett); Departments of Psychiatry, Neurology, and Physical Medicine and Rehabilitation, University of Colorado and Denver Veteran's Medical Center, Denver (Dr Brenner); Rocky Mountain MIRECC, Denver, Colorado (Ms Stearns-Yoder); and Departments of Physical Medicine and Rehabilitation (Dr Stevens) and Psychology (Mr Rothman), Virginia Commonwealth University, Richmond.

Published: October 2020

AI Article Synopsis

  • Constraint-induced movement therapy (CI therapy) helps individuals with upper extremity hemiparesis reduce disability after neurological injuries, including traumatic brain injury.
  • The BRAVE Project is a randomized controlled trial using CI therapy, involving intensive training of the affected arm, behavioral shaping techniques, and strategies to apply learned skills in daily life.
  • The study focuses on improving motor function, with the main measurement being the Motor Activity Log, while also collecting diverse secondary data on various health and lifestyle factors.

Article Abstract

Constraint-induced movement therapy (CI therapy) has been shown to reduce disability for individuals with upper extremity (UE) hemiparesis following different neurologic injuries. This article describes the study design and methodological considerations of the Bringing Rehabilitation to American Veterans Everywhere (BRAVE) Project, a randomized controlled trial of CI therapy to improve the motor deficit of participants with chronic and subacute traumatic brain injury. Our CI therapy protocol comprises 4 major components: (1) intensive training of the more-affected UE for target of 3 hour/day for 10 consecutive weekdays, (2) a behavioral technique termed shaping during training, (3) a "transfer package," 0.5 hour/day, of behavioral techniques to transfer therapeutic gains from the treatment setting to the life situation, and (4) prolonged restraint of use of the UE not being trained. The primary endpoint is posttreatment change on the Motor Activity Log, which assesses the use of the more-affected arm outside the laboratory in everyday life situations. Data from a number of secondary outcome measures are also being collected and can be categorized as physical, genomic, biologic, fitness, cognitive/behavioral, quality of life, and neuroimaging measures.

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Source
http://dx.doi.org/10.1097/HTR.0000000000000460DOI Listing

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