Efficacy of Constraint-Induced Movement Therapy and mirror therapy in improving upper limb motor function and dexterity in post-stroke hemiparetic patients: a randomized controlled trial

Background. Stroke is among the leading causes of death and disability globally, leaving the patients with post-stroke hemiparesis approximately in 60% of stroke survivors. Upper limb (UL) impai rment, in particular fine motor function, poses significant challenges in daily living activities. Although Constraint-Induced Movement Therapy (CIMT) and Mirror Therapy (MT) have been employed to address these issues, limited research compares the effectiveness of each therapy. This study aimed to evaluate and compare the efficacy of CIMT and MT in improving dexterity and motor function in post stroke hemiparetic c patients, contributing to the existing knowledge of targeted rehabilitation strategies. Methods. A randomized controlled trial (RCT) was conducted with 120 post-stroke hemiparetic patients recruited from a hospital in Southern Italy between January 2022 and July 2024. Participants were divided into three groups (CIMT, MT, and a control group receiving only conventional therapy) and underwent treatment for 40 days. Outcome measures included manual dexterity (Nine Hole Peg Test), Background Stroke is the second most common cause of death glo bally and the third leading cause of disability worldwide,(1) characterized by ischemic or hemorrhagic cerebrovascular diseases that cause focal neurological deficits depending on the area of the brain affected.(2) Among the various damage it can cause, ranging from cognitive to motor hand strength (Hand Grip Strength Test), and functional independence (Barthel Index, Quick DASH, and Modified Rankin Scale). Results. Statistically significant improvements were observed in both the CIMT and MT groups compared to controls, with notable gains in dexterity, motor function, and independence in ADLs. No statistically significant differences emerged between CIMT and MT in overall efficacy, though CIMT demonstrated a slightly greater impact on motor strength. Conclusions. Both CIMT and MT are effective and safe adjuncts to conventional rehabilitation, enhancing UL recovery in post-stroke patients. This study is the first RCT to directly compare CIMT and MT, offering insights into optimized rehabilitation strategies. Future studies should examine long-term impacts and explore home-based application feasibility.