Effect of modified Constraint induced movement therapy on hemineglect in acute stroke: A randomized controlled trial

This study investigates the impact of Modified Constraint Induced Movement Therapy (mCIMT) on patients suffering from hemineglect following an acute stroke. Hemineglect, typically resulting from right hemispheric strokes, is a neuropsychological condition where the patient fails to attend to the side of space opposite the brain lesion. It significantly hampers functional recovery and quality of life.The intervention group will receive Modified Constraint Induced Movement Therapy (mCIMT) in addition to conventional physiotherapy. mCIMT involves restricting the unaffected upper limb using a mitt or padded glove for 3 to 4 hours daily during waking hours. This is combined with structured, task-specific training sessions where the patient performs repetitive, functional activities using the affected arm. Tasks may include reaching, grasping, feeding, and writing—chosen to simulate daily life activities and promote awareness of the neglected side.The therapy is delivered in daily 30-minute sessions of mCIMT plus 45 minutes of conventional therapy over 7–8 consecutive days. The control group will receive only conventional therapy, including positioning, ROM exercises, strengthening, ADL training, and gait activities.The study uses two primary outcome measures to evaluate the effectiveness of the intervention. The **Catherine Bergego Scale (CBS)** assesses the severity of hemineglect by observing patients during daily activities, with scores ranging from 0 (no neglect) to 30 (severe neglect), and also captures the patient’s awareness of their condition (anosognosia). The **Fugl-Meyer Assessment for Upper Extremity (FMA-UE)** evaluates motor function, reflexes, and coordination of the affected upper limb through 33 items scored from 0 to 2, categorizing motor ability from poor to full capacity. Together, these tools provide a detailed picture of both functional and motor recovery in stroke patients.