constraint induced movement therapy?

Constraint-induced movement therapy (CI) forces the use of the affected side by restraining the unaffected side. With CI therapy, the therapist constrains the survivor’s unaffected arm in a sling. The survivor then uses his or her affected arm repetitively and intensively for two weeks.

Dr. Edward Taub, a professor of psychology at the University of Alabama in Birmingham, developed CI therapy. He says that after a stroke, a survivor tries unsuccessfully to use the affected side. Their initial failure discourages them from using that side. Dr. Taub calls this “learned non-use.”

After her stroke in 1999, Reva Baughman, 61, of La Crescenta, Calif., could hardly lift her left arm or move her fingers. This year, she underwent CI therapy at the Advanced Recovery Rehab Center in Sherman Oaks, Calif. Therapy lasted six hours a day, five days a week, for three weeks.

Today she can raise her arm, hold a bottle steady in her hand and feed herself sandwiches and cookies with her left hand. “Before CI therapy, I did not even try to use my affected hand and arm,” she says. “Now I try new things every day with my left arm and hand. I have the impetus to try.”

In order to use CI therapy, survivors need to be able to extend their wrists and move their arm and fingers. Numerous small studies show CI therapy improves movement on the affected side. A June 2000 study published in Stroke: Journal of the American Heart Association also showed that brain activity actually improves with the treatment.

“This finding offers hope to researchers who believe it may be possible to stimulate or manipulate brain areas to take over lost functions, a process known as cortical reorganization,” says Dr. Taub.

Currently, researchers are studying whether CI therapy improves arm and shoulder movement three-to-six months after stroke and if the gains last over a period of two years.

At this time, medical insurance does not reimburse for CI therapy. It costs about $5,000 for two weeks of treatment