Constraint-induced movement therapy (CI or CIMT) is a form of rehabilitation therapy that improves upper extremity function in
stroke and other
central nervous system damage victims by increasing the use of their affected upper limb.
CIMT was developed by
Edward Taub of the
University of Alabama at Birmingham. Taub argues that, after a stroke, the patient stops using the affected limb because they are discouraged by the difficulty.
As a result, a process that Taub calls "
learned non-use"
sets in, furthering the deterioration. Learned non-use is a type of
negative feedback. Individuals are unable to move their affected limb or
the movements are inefficient and clumsy and in response to this a
suppression of movement occurs. It is this process that CIMT seeks to
reverse.
The American Stroke Association has written that Taub's therapy
is "at the forefront of a revolution" in what is regarded possible in
terms of recovery for stroke survivors.
As a result of the patient engaging in repetitive exercises with the affected limb, the brain grows
new neural pathways. This change in the brain is referred to as cortical reorganization or
neuroplasticity. One study by Deluca et al. showed that using
Transcranial Magnetic Stimulation (TMS) that the excitable cortex of the affected cortex in adults patients with HCP doubled in size after 12 days of therapy.
Recently, the possible benefits of cortical reorganization has led to
studies of CIMT on children because neuroplasticity is even greater
among children than adults.
Particular interest is growing in CIMT for children who have
cerebral palsy where one arm is more affected than the other.