Constraint Induced Therapy

CIMT - Intensive, task-specific neuro rehabilitation

Constraint Induced Movement Therapy (CIMT or CIT) is an intensive behavioural rehabilitation programme designed to ‘rewire the brain’ and enable improved use of the affected limb in day to day activities. Physio4You is one of the few Neurological Physiotherapy companies in the country to offer this evidence-based approach to neuro rehab, having completed training at the home of CIMT, The Taub Therapy Clinic at The University of Alabama.

What is CIMT?

Constraint induced movement therapy, provided at The Stevenage Clinic, is designed to improve the function of your weaker arm and or hand, or your weaker leg.

This neuro physio approach differs from conventional neurological rehabilitation in several ways, including the intensity, frequency and duration of treatment. Most importantly, behavioural techniques are used in conjunction with task practice activities to transfer your improved function and use of the affected limb into the real world environment.

As the title suggests, use of the non-affected side is constrained to increase the practice completed by the affected limb. The most visible aspect of this is the ‘mitten’ worn during treatment.

How does constraint induced movement therapy work?

 Learned non-use is thought to develop after the initial injury, such as a stroke, results in depressed central nervous system and stroke activity. This leads to a reduction in movement and unsuccessful attempts at movement. Compensatory movement strategies, whilst useful at times, can leads to further reinforcement and the less effective behaviour being reinforced. With less movement and little success in movement the brain area responsible for the affected body part contracts and the person can often become disillusioned with using the weaker side at all.  This suppression and masking of the more effortful movement is what leads to learned non-use and the person stopping using the weaker side, even if there is further recovery of movement.

Constraint induced movement therapy is thought to work in three main ways to reverse learned non-use, create neuroplasticity via repetitive task oriented training and by constraining use of compensatory strategies employed by the stronger side.

1
Increased motivation - Greater use of the affected side - Positive reinforcement of movement - Further practice
2
Use dependent changes in the brain resulting in alterations in the structure, function and connections.
3
Further practice and reinforcement.
4
Learned non-use reversed leading to a permanent change in use of the limb in real life situations.
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Could CIMT help your recovery?

Neurological Conditions Treated with CIMT

CIMT is most commonly used for people who have suffered a stroke, or other acquired brain injury which has resulted in loss of use of one side of the body, known as hemiplegia.

We use CIMT to treat the following conditions:

How Much Movement Do You Need?

Because the CIMT programme involves intensive, repetitive practice of movements, our neuro physios are careful to assess who will benefit. A constraint induced movement therapy programme requires commitment and hard work!

CIMT works well for people with some movement in the affected limb. For an upper limb programme, the person would usually have some movement at the shoulder and elbow. Ideally you would also have movement in your fingers, though this is not essential.

For those with a lower level of movement, we may integrate additional technology such as Functional Electrical Stimulation (FES), a Mobile Arm Support (MAS), splinting or Saebo products to enable a greater breadth of neuro rehab exercises to be completed.

Can CIMT help You?

If you're interested in having a conversation with one of our neuro physio team to see if constraint induced movement therapy will help you, please get in touch.

CIMT Programme Specifics

The Constraint Induced Movement Therapy Programmes at Physio4You are based on those used at The University of Alabama (USA) where CIMT originated and where we completed our training to prescribe CIMT.

Constraint
Constraint or restricted use of the stronger side.
Intensive Exercise
An intensive exercise programme and functional training for the weaker side.
Transfer Package
Support and structure to transfer the new gains into real life.
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