Scribd Logo
Upload

Welcome to Scribd!

  • 444 views

    CIMT

    Uploaded by

    Andi Noviqa Wulandari
    Constraint induced movement therapy (CIMT) is a rehabilitation technique that improves function in patients with stroke or other central nervous system injuries. It involves constraining the unaffected limb while intensively training the affected limb to perform functional tasks. CIMT has been shown to promote cortical reorganization and new neural pathways. It combines restraint of the less affected arm with repetitive practice of the more affected arm for several hours per day over 2-3 weeks. CIMT focuses on patients with stroke, cerebral palsy, or traumatic brain or spinal cord injuries who have some basic grasp and motor function in the affected limb.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    CIMT

    Uploaded by

    Andi Noviqa Wulandari
    444 views21 pages
    Constraint induced movement therapy (CIMT) is a rehabilitation technique that improves function in patients with stroke or other central nervous system injuries. It involves constraining the unaffected limb while intensively training the affected limb to perform functional tasks. CIMT has been shown to promote cortical reorganization and new neural pathways. It combines restraint of the less affected arm with repetitive practice of the more affected arm for several hours per day over 2-3 weeks. CIMT focuses on patients with stroke, cerebral palsy, or traumatic brain or spinal cord injuries who have some basic grasp and motor function in the affected limb.

    Original Description:

    constraint induced

    Copyright

    © Attribution Non-Commercial (BY-NC)

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Constraint induced movement therapy (CIMT) is a rehabilitation technique that improves function in patients with stroke or other central nervous system injuries. It involves constraining the unaffected limb while intensively training the affected limb to perform functional tasks. CIMT has been shown to promote cortical reorganization and new neural pathways. It combines restraint of the less affected arm with repetitive practice of the more affected arm for several hours per day over 2-3 weeks. CIMT focuses on patients with stroke, cerebral palsy, or traumatic brain or spinal cord injuries who have some basic grasp and motor function in the affected limb.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    444 views21 pages

    CIMT

    Uploaded by

    Andi Noviqa Wulandari
    Constraint induced movement therapy (CIMT) is a rehabilitation technique that improves function in patients with stroke or other central nervous system injuries. It involves constraining the unaffected limb while intensively training the affected limb to perform functional tasks. CIMT has been shown to promote cortical reorganization and new neural pathways. It combines restraint of the less affected arm with repetitive practice of the more affected arm for several hours per day over 2-3 weeks. CIMT focuses on patients with stroke, cerebral palsy, or traumatic brain or spinal cord injuries who have some basic grasp and motor function in the affected limb.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 21

    Janeane Jackson

    What is CIMT?
    Constraint Induced Movement Therapy (CI or
    CIMT)- Is based on research done by Edward Taub and
    is a form of rehabilitation therapy that improves upper

    extremity function in patients suffering from a stroke or


    other Central Nervous System complications by increasing the use of their affected upper limb.

    CIMT
    Combines constraint of the unaffected limb and intensive use of the affected limb. Uninvolved extremity is placed in a mitt, sling or splint performing supervised structured tasks with the affected limb Patients learn to improve the motor ability of the more affected parts First rehabilitation modality to show progress and changes on how neurological injuries are studied and treated

    CIMT

    Goal purposeful movements when performing functional tasks.

    Shaping the use of the affected limb Cortical Reorganization teaches the brain to grow new neural pathways.

    CIMT
    Modified (CIMT) - is a short-term, intensive treatment
    based on overcoming learned non-use in the weaker arm/hand and
    improving motor skills and coordination in this arm/hand. This is achieved through placing a splint or cast on the stronger arm/hand for a three-week period while incorporating intensive motor training with other arm/hand.

    CIMT
    How Does Modified CIMT Work? It influences the brain to develop connectivity that improves motor function. The brain changes itself when the affected extremity is involved intensive

    and repetitive activity.

    CIMT
    Who Qualifies for Modified CIMT? The individual needs to have a basic grasp/release to be

    eligible for the program. They also need to be safe for


    mobility while having one hand in a cast a three-week period of at least two hours of direct, one-to-one treatment

    three times per week and following a HEP

    CIMT: Three Components

    Repetition, structure, intense practice of the affected


    arm Restraint of the less-affected arm

    Monitored arm use in life situations and problem


    solving to overcome barriers

    CIMT Patients

    CIMT is focused on three patient populations:


    Stroke

    Cerebral Palsy (Pediatrics)


    TBI/Spinal Cord Injuries

    http://youtu.be/zwlmB4U-Udo

    Learned Non-use
    Result of an upper motor neuron lesion that depresses the central nervous system and motor activity after a stroke Use of the uninvolved extremity more often to compensate for

    lack of movement in the involved extremity


    Learn to NOT use the involved extremity

    Qualifications for Treatment


    10 x 10 x 10
    10 degrees active wrist extension

    10 degrees active thumb abduction


    10 degrees active extension of any other two digits on affected hand

    Protocol
    Restraint of unaffected arm for 90% of waking hours 2 to 3 week period, 6 to 7 hours per day of intense therapy on consecutive weekdays Repetitive training of more affected UE Behavioral agreement Treatment diary

    Therapist Intervention
    In people with ongoing limitation of arm function after stroke, providing 6 hours of therapist-guided task practice was equivalent to 1 hour of direct therapy with 5 hours home practice over 10 days. Gains after two weeks of intense practice were not sustained at six months. Richards, L. et al., 2006

    Advantages to CIMT
    Overall greater improvements in function vs. conventional treatment

    Highly researched and credible treatment approach


    Increases daily/social participation Decrease in medical cost over lifetime

    Disadvantages to CIMT
    Requires enormous labor from both patient & medical
    staff

    Patient endures many hours of frustration


    Patients can suffer from muscle soreness resulting in stiffness and discomfort in the involved upper extremity as well as skin lesions and skin burns.

    Disadvantages to CIMT
    Not beneficial for all stroke/B
    Typically for patients with higher level of function Longer treatment = higher cost to patient Not reimbursable through insurance Acute CIMT can be harmful by increasing the size of the lesion.

    The Extremity Constraint Induced Therapy Evaluation Trial (EXCITE)


    Represents the first national, randomized, single-blind study to systematically test a neurorehabilitation therapy among patients with the ability to initiate extension movements at the wrist and fingers, and who experienced their first stroke within 3 to 9 months prior to enrollment.

    The Extremity Constraint Induced Therapy Evaluation Trial (EXCITE)


    Outcome Measures
    Wolf Motor Function Test
    15 timed tasks: sequentially from simple to complex 2 strength tasks: Shoulder flexion & grip strength

    Motor Activity Log


    11 point Quality of Movement (QOM) scale

    11 point Amount of Use (AOU) scale


    Subjective, done by patient

    Brain Mapping Measures Newer Outcome Measures of CIMT


    Voxel-Based Morphometry (VBM)- is a neuroimaging analysis technique that allows investigation of focal differences in brain anatomy Magnetic Resonance Imaging (MRI)-radiographical

    imaging device portrayed by pixels.

    Brain Mapping Measures Newer Outcome Measures of CIMT


    Transcranial Magnetic Stimulation (TMS) - uses electromagnetic induction to induce weak electric currents using a rapidly changing magnetic field; this can cause activity in specific or general parts of the brain.

    REFERENCES
    Taub, E. et al. Constraint-induced movement therapy: a new family of techniques with broad application to physical rehabilitation a clinical review. Journal of Rehabilitation Res Dev. 1999; 36:237-251. Taub, E. et al. Constraint induced manual therapy and massed practice. Stroke. 2000; 31:983-991. Richards, L. et al. Limited dose response to ConstraintInduced Movement Therapy in patients with chronic stroke. Clinical Rehabilitation 2006; 20: 1066-1074

    Sterr, A. et al. Longer versus shorter daily constraint-induced movement therapy of chronic hemiparesis: and exploratory study. Archives of Physical Medicine & Rehabilitation. 2002; 83:1374-1377.

    You might also like