The purpose of this pilot study was to investigate the effects of the Keys treatment protocol in use, motor function of the affected UE and disability following stroke.
10 adults with chronic stroke (>6 months) with minimum movement on the shoulder, elbow, wrist, and fingers on the affected upper extremity (UE) were included. Participants received the Keys intervention protocol over an 8-week period, including all elements of the traditional CIMT except for the following modifications: 1) 22 session of 1.5 hours, distributed as follows: 4 days/week for the first 4 weeks, 2 days/week for weeks 5 and 6, and 1 day/week for weeks 7 and 8; 2) restraint mitt on the less-affected UE for 8 weeks; 3) modified transfer package to accommodate the longer intervention period. Outcome Measures included the Motor Activity Log, Wolf Motor Function Test, Stroke Impact Scale, Zung Depression Scale, and the Canadian Occupational Performance Measure. Outcomes were administered pre- (T1), during (4 weeks into the intervention, T2), and post-treatment (after 8 weeks of the intervention, T3).
On average, participants improved in all outcomes when comparing the scores obtained at T1, T2 and T3. The largest difference was observed at the T2 when compared to the T1
The pilot study findings suggest that the KEYS protocol improves use of the affected UE, motor function, occupational performance, mood, and quality of life. The largest difference on these scores was observed in the middle of the intervention, except for ADL performance, mobility, and social participation domains on the SIS.
The Keys protocol for CIMT could enhance therapists’ acceptability of and payment for CIMT and improve the feasibility of delivering the evidence based intervention. This pilot study suggests that this could be done effectively.
Musculoskeletal: upper limb
Disability and rehabilitation
