The Importance of Motivation and Dropping Out from Treatment in Constraint-induced Movement Therapy for Stroke Patients

Choi, Soo Won; Kim, Kyong Mi; Jang, Soon Ja; Kim, Hyung Joon; Kim, Seung Su; Son, Mi Ok; Oh, Sun Young; Yoo, Yeon Hwan; Seo, Ji Hyun

Abstract

OBJECTIVE
To assess the effect of motivation for treatment and to find out causes of dropping out from treatment in performing the constraint-induced movement therapy (CIMT). METHOD: Forty six stroke patients were treated with CIMT for 2 weeks. Prior to and after treatment, Fugl-Meyer motor assessment (FMA), Wolf motor function test (WMFT), box and block test (BBT), and 9 hole peg test, motor activity log (MAL) were performed, and for the evaluation of treatment motivation, motivation score (MS) was assessed in 24 patients.
RESULTS
After 2 weeks of CIMT treatment, the mean value of FMA increased by 15.1%, WMFT by 19.5%, BBT by 35.8%, the time of 9 hole peg test decreased by 20.2%, and the "How well" sub-score of the increased MAL was 59.6% (p<0.05). Larger improvement of FMA score was observed in patients with high MS (p<0.05). Twelve out of 46 patients were dropped, 5 patients (18.5%) among 27 right side hemiplegic patients and 7 patients (38.9%) of 19 left side hemiplegic patients gave up the treatment in the middle, and the MS score of the quitted patients (35.3 point) was lower than that of patients who did not quit (40.5 point) (p<0.05).
CONCLUSION
After 2 weeks of CIMT treatment, larger improvement of movement capacity was observed in patients with high motivation. Among patients with low treatment motivation and old age, many patients were dropped out during CIMT.