Constraint Induced Movement Therapy (CIMT)

Communikare Services

Constraint-Induced Movement Therapy (CIMT)

Constraint-Induced Movement Therapy (CIMT) is a series of rehabilitation procedures
meant to alleviate functional issues in the most affected upper extremity of stroke patients.
90% of waking hours are spent with the less-affected arm immobilized, typically with a sling
or mitt, while the more-affected arm is intensively encouraged to be used. Six hours per day,
for two to three weeks, are typically devoted to concentrated, repetitive therapy of the more
afflicted limb. Important considerations include the patient’s compliance with the severe
constraint and training programme, as well as the requisite intensity of therapy delivered by
therapists in a clinical setting.
Modified CIMT (mCIMT) is a less intense treatment that employs the same concepts as
CIMT (i.e., restraint of the less-affected upper extremity and practise of functional activities
of the more-affected extremity), but with less intensity than conventional CIMT (i.e. less
time). Concentrated, repeated actions with the more afflicted arm are a component shared by
all CIMT treatments.
The majority of functional benefits appear to be restricted to people with active wrist and
hand mobility. Studies have examined the effectiveness of this intervention for improving
post-stroke functional outcomes.

Components of CIMT

Constraint-induced movement therapy (CIMT) is a rehabilitation approach that is designed to
improve the use and function of a limb that has been affected by a neurological injury or
condition, such as stroke or traumatic brain injury. CIMT typically involves the following

  1.  Constraint of the unaffected limb: The unaffected limb is typically placed in a restraint or
    splint to prevent its use during therapy sessions and other activities. This forces the
    individual to use the affected limb, which can help to improve its function and use.
  2.  Repetitive task practice: The individual engages in a series of tasks and activities that
    require the use of the affected limb. These tasks may be simple at first, such as reaching
    for objects or grasping a cup, and gradually become more complex as the individual’s
    ability improves.
  3.  Intensive therapy: CIMT typically involves a high number of therapy sessions over a
    short period of time, usually 10 to 14 consecutive days. This intensive approach is
    thought to help facilitate more rapid improvement in function.
  4.  Shaping and fading: The therapist uses techniques such as shaping and fading to
    gradually increase the difficulty of the tasks and activities that the individual is asked to
    perform. This helps to encourage the individual to continue to improve and progress in
    their therapy.
  5.  Homework: The individual is typically given tasks to practice at home, which can help to
    further, facilitate improvement in function and use of the affected limb.

CIMT is often used in conjunction with other rehabilitation approaches, such as occupational
therapy, physical therapy, and speech therapy, to help individuals recover from neurological
injuries and conditions.

CIMT Process

The goal of CIMT is to increase the use and strength of the affected limb and improve
functional independence.
The CIMT process typically involves the following steps:

  1.  Assessment: A therapist will assess the individual’s current functional abilities and
    determine the goals of the therapy.
  2.  Constraint: The unaffected limb is typically constrained using a sling or a cast to
    prevent its use. This forces the affected limb to perform tasks and movements.
  3.  Repetitive practice: The individual performs a variety of tasks and movements with
    the affected limb, such as reaching, grasping, and manipulating objects. These tasks
    are typically repeated multiple times a day to promote motor learning and skill
  4.  Task-specific training: The individual practices functional tasks that are specific to
    their daily activities, such as dressing, bathing, and cooking.
  5.  Transfer of skills to everyday life: The skills and movements learned during CIMT
    are transferred to real-life activities to promote functional independence.

CIMT is typically administered by a therapist in a clinical setting, but it may also involve
home-based exercises and activities. It is usually combined with other therapies, such as
physical therapy, occupational therapy, and speech therapy, to maximize functional

Hand Rehab using CIMT

Depending on the specific impairments and goals of the individual. Some common
strategies to improve hand function include:

  1.  Occupational therapy: This type of therapy focuses on improving the functional use
    of the hands through activities of daily living (ADLs), such as dressing, bathing, and
    eating. Occupational therapists may use a variety of techniques, including
    task-specific training, splinting, and assistive devices, to improve hand function.
  2.  Physical therapy: Physical therapists can work with individuals to improve muscle
    strength, range of motion, and coordination in the hands through exercises and other
  3.  Surgery: In some cases, hand surgery may be necessary to improve hand function.
    This may include procedures to repair damaged tendons or nerves, or to realign or
    stabilize bones in the hand.
  4.  Medications: Depending on the cause of the hand impairments, medications may be
    prescribed to reduce inflammation or improve muscle function.
  5.  Assistive devices: There are many different types of assistive devices available to
    help individuals with hand impairments perform ADLs more easily. These may
    include adapted utensils, adapted keyboards and mice, and other devices.

It is important to work with a healthcare provider, such as a doctor, occupational therapist,
or physical therapist, to develop a customized treatment plan to improve hand function.

Advantages of CIMT

  • Constraint-induced movement treatment, or CIMT, has been demonstrated to
    considerably enhance a person’s upper limb function, resulting in higher use and
    improved movement quality of the weaker arm.
  •  Acquiring new motor abilities
  • Increased usage of the afflicted arm for functional tasks such as dressing, eating,
    lacing shoes, and brushing teeth
  • Enhanced quality of motion
  • Increased autonomy with everyday duties
  • Enhanced feeling of well-being
  • Superior quality of life.

CIMT is an intensive form of therapy with long-term efficacy, but the commitment to the
program is essential for maximizing the benefits of treatment. Following CIMT therapy,
patients frequently experience considerable improvements in hand function, which can have
a profound impact on their independence and quality of life.

Who is Appropriate for CIMT?

Constraint-induced movement therapy (CIMT) is appropriate for both children and adults
with one upper limb handicap due to brain damage at birth, throughout development, or
later in life. CIMT has been demonstrated to be especially beneficial for stroke victims.

  • Spinal Cord Damage
  • Multiple Sclerosis
  • Cerebral Palsy
  • TBI (traumatic brain injury)

Our therapists will conduct an initial screening examination of patients to verify their
appropriateness and provide an outline of the whole programme, which will be tailored to
the person’s specific requirements and objectives.

The Communikare CIMT service includes:

  • Restraint of the uninjured upper extremity by a mitt, cast, or glove
  • Utilization of the afflicted upper extremity during brief, organised tasks.
  • Activities pertinent to the individual’s everyday function
  • Homework that encourages the individual to use their weaker arm outside of the

CIMT is an intensive form of therapy meant to obtain maximal benefit in a short period of
time for long-term functional gains; as such, it needs a person’s total dedication to the
programme. Throughout the programme, support and encouragement are supplied.
Modifications are made to our CIMT programmes for youngsters in order to maximise their
engagement in therapy.
Although the same concepts apply, the therapist will focus the therapeutic tasks on play
activities to encourage the kid to utilise the weaker arm while the healthy arm is
Examples of functional tasks performed during a treatment session with children include:

  • Stacking bricks
  • Shuffling cards
  • Ball games
  • Using playdough
  • Grasping and reaching for items

Our paediatric CIMT-trained physiotherapists employ a wide variety of equipment, such as
toys and games, to keep children’s interest and make their therapy entertaining and
effective. Parents will be actively involved in the programme and will be instructed on
appropriate tasks to complete with their kid outside of the clinic in order to help their child
reach his or her full potential.

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