The purpose of this study was to investigate the effects of constraint-induced (CI) movement using self-efficacy on U/E function of chronic hemiplegic patients. CI movement discourages the use of the unaffected U/E, combined with intensive training of the affected U/E.

A non-equivalent pretest-posttest design was used. Study subjects were 40 hemiplegic patients conveniently selected from 2 different community health centers. The experimental subjects participated in the CI movement program for 6 hours daily over a period of two weeks. The exercises for affected U/E consisted of warming up, main exercise and ADL practice. To encourage the participants' behaviors self-efficacy enhancing strategies were used, which included performance accomplishment, vicarious experience, verbal persuasion and emotional arousal.

After 2 weeks of treatment, the grip power, pinch power, wrist flexion/extension, elbow flexion, and shoulder flexion/extension were significantly higher in the experimental subjects than in the control subjects. However, there was no significant difference in hand functions of the two groups.

The above results show that the constraint-induced movement using self-efficacy could be an effective nursing intervention for improving U/E function of chronic hemiplegic patients. Long term studies are needed to determine the lasting effects of constraint-induced movement.

The purpose of this study was to investigate the effects of exercise training using biofeedback and constraint-induced movement on the upper extremity function of hemiplegic patients.

A non-equivalent pretest-posttest design was used. Study subjects were a conveniently selected group of 40 hemiplegic patients(20 experimental subjects, 20 control subjects) who have been enrolled in two community health centers. After biofeedback training the subjects of experimental group were given constraint-induced movement, involving restraint of unaffected U/E in a sling for about 6 hours in a day over a period of two weeks, while at the same time intensively training the affected U/E. Outcomes were evaluated on the basis of the U/E motor ability(hand function, grip power, pinch power, U/E ROMs), and motor activity(amount, quality).

1. After 2 weeks of treatment, the motor abilities of affected U/E(hand function, grip power, pinch power, ROMs of wrist flexion, elbow flexion and shoulder flexion/extension) were significantly higher in subjects who participated in exercise training than in subjects in the control group with no decrement at 4-week follow-up. However, there was no significant difference in wrist extension between experimental or control group. 2. After 2 weeks of treatment, the amount of use and the quality of motor activity of affected U/E were significantly higher in subjects who participated in exercise training than in subjects in the control group with no decrement at 4-week follow-up.

The above results state that exercise training using biofeedback and constraint-induced movement could be an effective intervention for improving U/E function of chronic hemiplegic patients. Long-term studies are needed to determine the lasting effects of constraint-induced movement.