Constraint induced movement therapy or CIMT is a physiotherapy technique used to improve a person’s upper limb function following neurological damage. After a neurological event, such as a stroke. it is common for patients to develop learned non-use of their weaker arm. Research shows that intense repetitive task practice using the weaker arm can improve both the amount of use and quality of movement leading to improved function and independence.

CIMT involves two main components:

• Restraint of the unaffected arm using a mitt, sling or cast to encourage use of the weaker arm
• Repetitive practice of functional tasks with the weaker hand. Activities may include picking up or stacking small objects and functional everyday tasks

CIMT works by encouraging reorganisation of the brain so that a larger part becomes active when the person uses their weaker arm. The person also develops an improved awareness and motivation to use their weaker arm thereby overcoming the cycle of learned non-use.

How does CIMT Work?

Constraint induced movement therapy or CIMT is centred on retraining the brain following damage to improve functional use of the weaker arm and hand.

Evidence has shown that practising exercises with the weaker arm while restraining the normally functioning arm over a period of time leads the brain to rewire itself. This then allows the person to learn new motor activities or relearn motor skills that may have been lost.

CIMT may be used shortly after neurological injury, to make the most of the brain’s ability to change during this period. It is also suitable for people in the later stages of rehabilitation whose progress may have plateaued.

Improvements in hand function are achieved by:

• Intense, repetitive task practise using the weaker arm
• Reduced compensatory activity with the unaffected side by restraint in a mitt/glove
• Re-directing the person’s attention to the weaker arm by focusing on using this arm in structured activities and functional tasks.
• Repeating these activities over a period of time that result in successful and positive experiences with the weaker arm.
• Increasing the person’s motivation to use the weaker arm, through success in fun and interesting activities that may have seemed impossible before.

Benefits of CIMT:

• Research has shown that constraint induced movement therapy or CIMT can significantly improve a person’s upper limb function leading to increased amount of use as well as improved quality of movement of the weaker arm.
• Acquisition of new motor skills
• Increased use of the affected arm in functional activities such as dressing, eating, tying shoe laces and brushing teeth
• Improved quality of movement
• Enhanced independence with everyday tasks
• Improved sense of well being
• Improved quality of life

CIMT is an intense form of therapy with long term success but commitment to the program is vital in order to get the most out of your treatment. Following CIMT therapy people often go on to make significant improvements in hand function which can have a profound effect on independence with everyday activities and quality of life.

Who is Suitable for CIMT?

• Constraint induced movement therapy (CIMT) is suitable for both adults and children with impairment of one upper limb, related to damage to the brain at birth, during development or later on in life. CIMT has been proven to be particularly effective for stroke patients.
• Spinal Cord Injury
• Multiple Sclerosis
• Cerebral Palsy
• TBI (traumatic brain injury)

Our therapists will conduct an initial screening assessment of patients to determine suitability and outline details of the full programme which will be tailored to the person’s individual’s needs and goals.

The CIMT programme at Rehab Basics involves:

• Restraint of the unaffected upper limb in a mitt, cast or glove
• Repetitive use of the affected upper limb during short, structured tasks
• Functional tasks relevant to the person’s everyday function
• Homework assignments that encourage the person to use their weaker arm outside of the clinic setting

CIMT is an intense form of therapy designed to achieve maximum benefit over a short period of time for long term functional gains; it therefore requires a person’s full commitment to the programme. Support and encouragement is provided throughout the programme. 

Our CIMT programmes for children are modified in order to maximise their participation in therapy.
Although the same principles apply the therapist will centre the therapeutic tasks around play activities to facilitate use of the child’s weaker arm whilst the unaffected arm is restrained.

Functional activities completed in a therapy session for children may include:

• Stacking blocks
• Turning cards
• Ball play
• Using playdough
• Reaching and grasping objects

Our paediatric CIMT trained physiotherapists use a wide variety of equipment including toys and games to help maintain interest and make therapy enjoyable and effective for children. Parents will be actively involved in the programme and will be taught appropriate activities to complete with their child outside the clinic setting in order to help fulfil their child’s potential.

Treatment Sessions are offered in clinics across Northamptonshire and Milton Keynes or at Home Environment.

For further information about our service or to book an appointment with Rehab Basics please contact us.