Stroke Recovery - Current Perspectives and Therapeutic Avenues - Motor Re-learning - Constraint-induced Movement Therapy

Constraint-induced Movement Therapy

The idea for constraint-induced therapy is actually at least 100 years old. Significant research was carried out by Robert Oden. He was able to simulate a stroke in a monkey's brain, causing hemiplegia. He then bound up the monkey's good arm, and forced the monkey to use his bad arm, and observed what happened. After two weeks of this therapy, the monkeys were able to use their once hemiplegic arms again. This is due to neuroplasticity. He did the same experiment without binding the arms, and waited six months past their injury. The monkeys without the intervention were not able to use the affected arm even six months later. In 1918, this study was published, but it received little attention.

Eventually, researchers began to apply his technique to stroke patients, and it came to be called constraint-induced movement therapy. Notably, the initial studies focused on chronic stroke patients who were more than 12 months past their stroke. This challenged the belief held at that time that no recovery will occur after one year. The therapy entails wearing a soft mitt on the good hand for 90% of the waking hours, forcing use of the affected hand. The patients undergo intense one-on-one therapy for six to eight hours per day for two weeks.

Evidence that supports the use of constraint induced movement therapy has been growing since its introduction as an alternative treatment method for upper limb motor deficits found in stroke populations. Recently, constraint induced movement therapy has been shown to be an effective rehabilitation technique at varying stages of stroke recovery to improve upper limb motor function and use during daily activities of living. The greatest gains are seen among persons with stroke who exhibit some wrist and finger extension in the effected limb. Transcranial magnetic stimulation and brain imaging studies have demonstrated that the brain undergoes plastic changes in function and structure in patients that perform constraint induced movement therapy. These changes accompany the gains in motor function of the paretic upper limb. However, there is no established causal link between observed changes in brain function/structure and the motor gains due to constraint induced movement therapy.

Read more about this topic:  Stroke Recovery, Current Perspectives and Therapeutic Avenues, Motor Re-learning

Other articles related to "therapy":

Constraint-induced Movement Therapy - Limitations To Implementation
... Presently, constraint-induced movement therapy (CIMT) has not been incorporated as part of standard practice for the rehabilitation of the hemiplegic upper extremity ... Costs are generated due to the intensity of therapy required for CIMT, as participants typically receive up to 6 hours of one-on-one therapy at least 5 days per week for 2 weeks ... use, lack of facilities, the cost of providing one-on-one therapy sessions, and the opportunity costs associated with the therapist’s inability to see and treat other patients during that ...
Silver Spring Monkeys - Constraint-induced Movement Therapy
... work with the Silver Spring monkeys, Taub went on to develop novel physical therapy techniques to help stroke victims, and those with other forms of brain injury, regain ... The American Stroke Association regards Taub's therapy, known as constraint-induced movement therapy (CI), as "at the forefront of a revolution" in ... With CI therapy, the patient is forced to use the affected limb, to whatever minimal extent he can, by having the unaffected one restrained ...

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