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This is the largest (n = 222) RCT of CIMT, and because of its size and design, it continues to provide important longitudinal data on the efficacy of CIMT. The fact that its control group is not fully dose matched is an important lesson that will improve the design of future trials
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Observation of amounts of movement practice provided during stroke rehabilitation
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In spite of patients' and researchers' appetite for applying technology to rehabilitation, this moderate-size RCT demonstrates that efficacy cannot be assumed. Studies are required to match the intervention to the patient to make the best use of limited resources and avoid training in vain
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• Plow EB, Carey JR, Nudo RJ, et al.: Invasive cortical stimulation to promote recovery of function after stroke: a critical appraisal. Stroke 2009, 40(5):1926-1931. An important analysis of how failing to take into account the physiologic complexities of the system under study can lead to the failure of a phase 3 trial.
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