Constraint Induced Movement Therapy (CIMT)
Books to read
- O’sullivan - Ch12 CIMT1
CIMT is a method of forced-use designed to Promote Increased Use of an impaired UE. This intervention can be applied in the clinic and at home.
Mechanism
CIMT works through two main mechanisms:
- Learned Nonuse
- Use-Dependent Brain Plasticity
Results
Indications
Notes from class
Research supports use for Mild to Moderate UE Hemiparesis
Main elements
Class notes
- Intensive Training of the More-Impaired UE for Multiple days
- Training with a behavioral technique termed Shaping
- Applying a “Transfer Package” of adherenceenhancing behavioral methods designed to transfer gains made in the research laboratory or clinical setting to the patient’s real-world environment
- Inducing the patient to use the more-impaired UE during waking hours over the course of tx, usually by restraining the less-impaired UE
Task Oriented Training
Task oriented training includes:
Example
participant is executing a shaping task involving unscrewing a nut from a bolt (A) at a lower level of complexity, with the bolt placed closer to her, and (B) at a higher level of complexity, with the bolt placed farther away.1
Adherence-enhancing behavioral strategies
(i.e., transfer package)
- Daily administration of the Motor Activity Log (MAL)1
- Home diary1
- Problem-solving to overcome apparent barriers to use of the more-affected UE in the real-world situation1
- Behavioral contract1
- Caregiver contract1
- Written home skill assignment with check-off list to determine adherence1
- Home practice1
- Daily schedule1
- Weekly phone calls for the first month after treatment to administer the MAL and problem-solve1
Constraining use of the more-affected UE
CPG / Effectiveness
References
1.
O’Sullivan SB, Schmitz TJ, eds. Improving Functional Outcomes in Physical Rehabilitation. 2nd ed. F.A. Davis Company; 2016.
Citation
For attribution, please cite this work as:
Yomogida N, Kerstein C. Constraint Induced
Movement Therapy (CIMT). https://yomokerst.com/The
Archive/Interventions/Constraint Induced Movement
Therapy/constraint_induced_movement_therapy_CIMT.html