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The site is about The Extremity Constraint-Induced Therapy Evaluation study.

Profoundly impaired motor dysfunction is a major consequence of stroke. As a result, a large number of the more than 700,000 people in America sustaining a stroke each year have limitation in motor ability and compromise quality of life.

Our Exciting Clinical sites:

Emory University

Ohio State

University of Alabama at Birmingham

University of Florida

University of North Carolina/Chapel Hill

University of Southern California

Wake Forest University

Our Data Management Center:

Washington University School of Medicine

Description of this study:

The National Center for Medical Rehabilitation Research has funded the EXCITE (Extremity Constraint Induced Therapy Evaluation) randomized clinical trial. A portion of this 5-year study is also supported by the National Institute of Neurological Diseases and Stroke. This work is believed to be the first multi-center clinical trial of a rehabilitation intervention to improve motor function in patients after stroke. The study will enroll patients who had sustained a stroke 3-12 months earlier. The Principal Investigator is Steven L. Wolf, Ph.D., PT, FAPTA (Emory University) and the Co-Principal Investigator is Carolee Winstein, Ph.D., PT (University of Southern California). Other site Principal Investigators include: Edward Taub, Ph.D., (University of Alabama Birmingham), Kathye Light, Ph.D., PT (University of Florida, Gainesville), Carol Giuliani, Ph.D., PT (University of North Carolina), David Good, M.D. (Wake Forest University), and Deborah Nichols, Ph.D., PT (The Ohio State University). The Data Management Center is located at Washington University (St. Louis) and is directed by J. Philip Miller.

Constraint-Induced Movement therapy or CI therapy is derived from the basic research of Dr. Taub with monkeys given differentiation of a single forelimb. This work gave rise to the idea that an intervention similar to that employed with monkeys would be effective for enhancing the rehabilitation of movement in humans after stroke. This approach was first applied in stroke patients as a “forced use” paradigm by Dr. Wolf at Emory University and extended and applied in many clinics and laboratories throughout the world by Dr. Taub.

The therapy involves constraining use of the better arm during waking hours for two weeks and training the weaker arm for 6 hours on each of the weekdays during that period. The treatment gains produced by this approach have been found to transfer to the activities of daily living in the life situation and have persisted for the two years that have been studied to date. Until now treatment has been carried out primarily in the chronic phase, more than one year after patients had sustained a stroke.

The present clinical trial has a blind cross over design and will determine whether less chronic patients, 3-12 months after stroke who are closer to the time window when they would normally be treated within the framework of the current health care system in this country.