#CIMT

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The term Constraint-Induced Movement Therapy (CIMT) describes a package of interventions designed to decrease the impact of a stroke on the upper-limb (UL) function of some stroke survivors. [1] It is a behavioural approach to neurorehabilitation[2] based on "Learned- Nonuse".

CIMT is typically performed for individuals following a cerebrovascular accident (CVA) as between 30-66% of CVA survivors will experience some functional loss in their impaired limb.[3] Furthermore, CIMT has also been performed for individuals with cerebral palsy (CP), traumatic brain injury (TBI) and multiple sclerosis (MS).The aim of CIMT is to improve and increase the use of the more affected extremity while restricting the use of the less affected arm.

The three major components of CIMT include:[1]

Repetitive, structured, practice intensive therapy in the more affected arm
Restraint of the less affected arm
Application of a package of behavioural techniques that transfers gains from the clinical setting to the real world (i.e. making it functional)
History
The term is derived from the studies of non-human primates in which somatosensory deafferentation of a single forelimb, after which the animal fails to use that limb. Originally developed by Dr Edward Taub who demonstrated that monkeys with a surgical deafferentation (i.e. somatic sensation was abolished) of a forelimb, ceased using the affected extremity.[4][5] Through failed attempts to use the deafferented forelimb, the monkeys developed compensation methods to avoid using the affected limb, that is, they effectively learned not to use their affected extremity termed learned nonuse.[4][5]
1. Morris DM, Taub E, Mark VW. Constraint-induced movement therapy: characterizing the intervention protocol. Eura Medicophys. 2006;42(3):257–68
2. Taub, E. and Uswatte, G. Constraint-induced movement therapy: answers and questions after two decades of research. 2006 NeuroRehabilitation, 21(2), 93-95.
3. Kwakkel, G., Kollen, B. J. and Wagenaar, R. C. Therapy impact on functional recovery in stroke rehabilitation: a critical review of the literature. 1999 Physiotherapy, 85(7), 377-391.
4. Uswatte, G., Taub, E., Morris, D., Barman, J., & Crago, J. Contribution of the shaping and restraint components of constraint-induced movement therapy to treatment outcome. 2006 NeuroRehabilitation, 21(2), 147-156.
5. Brogårdh, C. Constraint Induced Movement Therapy: influence of restraint and type of training on performance and on brain plasticity. 2006