scholarly journals Constraint-Induced Movement Therapy for Individuals After Cerebral Hemispherectomy: A Case Series

2009 ◽  
Vol 89 (4) ◽  
pp. 361-369 ◽  
Author(s):  
Stella de Bode ◽  
Stacy L Fritz ◽  
Kristi Weir-Haynes ◽  
Gary W Mathern
Keyword(s):  
Brain Imaging ◽  
Upper Extremity ◽  
Case Series ◽  
Movement Therapy ◽  
Constraint Induced Movement Therapy ◽  
Before And After ◽  
Block Test ◽  
Cortical Representations ◽  
The Brain ◽  
Qualitative Changes

Background and PurposeThis case report describes the feasibility and efficacy of the use of constraint-induced movement therapy (CIMT) in 4 individuals (aged 12–22 years) who underwent cerebral hemispherectomy (age at time of surgery=4–10 years). The aims of this case series were: (1) to evaluate the feasibility of this therapeutic approach involving a shortened version of CIMT, (2) to examine improvements that occurred within the upper extremity of the hemiparetic side, (3) to investigate the feasibility of conducting brain imaging in individuals with depressed mental ages, and (4) to examine changes in the sensorimotor cortex following intervention.Case DescriptionThe patients received a shortened version of CIMT for 3 hours each day for a period of 10 days. In addition, a standard resting splint was used for the unimpaired hand for an 11-day period. Each patient was encouraged to wear the splint for 90% of his or her waking hours. The following outcome measures were used: the Actual Amount of Use Test (AAUT), the Box and Block Test (BBT), and the upper-extremity grasping and motor portions of the Fugl-Meyer Assessment of Motor Recovery (FM).OutcomesImmediately after therapy, improvements were found in AAUT and BBT scores, but no improvements were found in FM scores. Three patients underwent brain imaging before and after therapy and showed qualitative changes consistent with reorganization of sensorimotor cortical representations of both paretic and nonparetic hands in one isolated hemisphere.DiscussionThe findings suggest that CIMT may be a feasible method of rehabilitation in individuals with chronic hemiparesis, possibly leading to neuroplastic therapy–related changes in the brain.

scholarly journals Application of Low-Intensity Modified Constraint-Induced Movement Therapy to Improve the Affected Upper Limb Functionality in Infantile Hemiplegia with Moderate Manual Ability: Case Series

Children ◽  
2020 ◽  
Vol 7 (9) ◽  
pp. 127
Author(s):  
Rocío Palomo-Carrión ◽  
Rita-Pilar Romero-Galisteo ◽  
Elena Pinero-Pinto ◽  
Purificación López-Muñoz ◽  
Helena Romay-Barrero ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Upper Limb ◽  
Case Series ◽  
Movement Therapy ◽  
Low Intensity ◽  
Constraint Induced Movement Therapy ◽  
Case Series Study ◽  
Quality Of Movement ◽  
Pre Treatment

Objective: To assess the functionality of the affected upper limb in children diagnosed with hemiplegia aged between 4 and 8 years after applying low-intensity modified Constraint-Induced Movement Therapy (mCIMT). Methods: Prospective case series study. A mCIMT protocol was applied for five weeks, with two hours of containment per day. The study variables were quality of movement of the upper limb, spontaneous use, participation of the affected upper limb in activities of daily living, dynamic joint position, grasp–release action, grasp strength, supination and extension elbow movements. Four measurements were performed, using the quality of upper extremity test (QUEST) scale, the Shriners Hospital for Children Upper Extremity Evaluation (SHUEE) Evaluation, a hand dynamometer and a goniometer. Results: The sample was composed of eight children with moderate manual ability. Statistically significant differences were detected in all the studied variables (p < 0.05) between the pre-treatment and post–treatment results (Week 0–Week 5), except for upper limb dressing, putting on splints and buttoning up. In the first week, the changes were statistically significant, except for protective extension, grasp strength, grasp–release and all functional variables (level of functionality and participation of the patient’s upper limbs) in the SHUEE Evaluation (p > 0.05). The greatest increase occurred in spontaneous use from Assessment 1 to Assessment 4 (p = 0.01), reaching 88.87% active participation in bimanual tasks. The quality of movement of the upper limb exhibited a significant value due to the increase in dissociated movements and grasp (p = 0.01). Conclusion: A low dose (50 h) of mCIMT increased the functionality of children diagnosed with congenital hemiplegia between 4 and 8 years of age with moderate manual ability.

Effects of mirror therapy vs modified constraint induced movement therapy on upper extremity in subacute stroke patients

2021 ◽  
Vol 20 (2) ◽  
pp. 323-329
Author(s):  
Kamatchi Kaviraja ◽  
G Tharani ◽  
G Yuvarani ◽  
N Kaviraja ◽  
Jenifer Augustina S ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Upper Limb ◽  
Movement Therapy ◽  
Systemic Hypertension ◽  
Mirror Therapy ◽  
Stroke Patients ◽  
Functional Index ◽  
Constraint Induced Movement Therapy ◽  
Subacute Stroke ◽  
The Brain

Objective: To compare and to examine the effectiveness of mirror therapy and modified constraint induced movement therapy (mCIMT) on upper extremity in subacute stroke patients. Background: Stroke or cerebral vascular accident is sudden dead of the brain cells due to inadequate blood flow. The WHO defines stroke as rapidly developing clinical signs of focal disturbance of cerebral function, with symptoms lasting for 24hrs or longer or leading to death, with no apparent cause other than of vascular origin. The most common consequence of stroke is loss of upper limb function. The protocol planned for improving the function of upper limb are mirror therapy and modified constraint induced movement therapy (mCIMT). Mirror therapy is a simple and inexpensive treatment which uses the visual information activating the premotor and motor cortex of the brain. This is explained by activation of so called mirrorneuron system. Whereas mCIMT utilises the redundant pathway in brain through neuro plasticity. Methodology: A total of 30 participants with subacute stroke were selected. The inclusion criteria are both gender of age 55-70 years and duration of 2-12 months of post stroke. Participants with mini mental state examination score<24, uncontrolled systemic hypertension, severe shoulder subluxation, previous stroke and severe cardiac failure were excluded. The outcome measures were measured using Upper Extremity Functional Index (UEFI) and Fugl Meyer Upper Extremity Scale. Procedure: All 30 participants with sub-acute stroke were divided into two groups. Both the group individuals were assessed for pre test using Fugl Meyer Upper Extremity Scale and Upper Extremity Functional Index Scale. Group A (15) was assigned to mirror therapy for 5 days a week, for 4 weeks and rest intervals was given. Similarly group B (15) was assigned to modified constraint induced movement therapy for 5 days a week, for 4 weeks. Both the groups were given conventional therapy for 20 mins. At the end of study subjects were assessed for post test using UEFI and Fugl Meyer upper extremity scale. Results: The Modified Constraint Induced Movement (mCIMT) is more effective than Mirror Therapy in improving the hemiparetic upper extremity in subacute stroke patients. Bangladesh Journal of Medical Science Vol.20(2) 2021 p.323-329

scholarly journals Efficacy of Constraint-Induced Movement Therapy for Post-Stroke Upper Extremity Hemiparesis Patients Attending a Day-Care Center

2009 ◽  
Vol 24 (6) ◽  
pp. 929-933
Author(s):  
Taichi KURAYAMA ◽  
Anna WATANABE ◽  
Minami TAKAMOTO ◽  
Nami SHIGETA ◽  
Yuki HASEGAWA ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Day Care ◽  
Care Center ◽  
Movement Therapy ◽  
Day Care Center ◽  
Post Stroke ◽  
Constraint Induced Movement Therapy

scholarly journals Predicting Improved Daily Use of the More Affected Arm Poststroke Following Constraint-Induced Movement Therapy

2019 ◽  
Vol 99 (12) ◽  
pp. 1667-1678 ◽  
Author(s):  
Mohammad H Rafiei ◽  
Kristina M Kelly ◽  
Alexandra L Borstad ◽  
Hojjat Adeli ◽  
Lynne V Gauthier
Keyword(s):  
Motor Activity ◽  
Retrospective Analysis ◽  
Upper Extremity ◽  
Probabilistic Neural Network ◽  
Movement Therapy ◽  
Individual Characteristics ◽  
Study Objective ◽  
Machine Learning Classification ◽  
Constraint Induced Movement Therapy ◽  
Ci Therapy

Abstract Background Constraint-induced movement therapy (CI therapy) produces, on average, large and clinically meaningful improvements in the daily use of a more affected upper extremity in individuals with hemiparesis. However, individual responses vary widely. Objective The study objective was to investigate the extent to which individual characteristics before treatment predict improved use of the more affected arm following CI therapy. Design This study was a retrospective analysis of 47 people who had chronic (&gt; 6 months) mild to moderate upper extremity hemiparesis and were consecutively enrolled in 2 CI therapy randomized controlled trials. Methods An enhanced probabilistic neural network model predicted whether individuals showed a low, medium, or high response to CI therapy, as measured with the Motor Activity Log, on the basis of the following baseline assessments: Wolf Motor Function Test, Semmes-Weinstein Monofilament Test of touch threshold, Motor Activity Log, and Montreal Cognitive Assessment. Then, a neural dynamic classification algorithm was applied to improve prognostic accuracy using the most accurate combination obtained in the previous step. Results Motor ability and tactile sense predicted improvement in arm use for daily activities following intensive upper extremity rehabilitation with an accuracy of nearly 100%. Complex patterns of interaction among these predictors were observed. Limitations The fact that this study was a retrospective analysis with a moderate sample size was a limitation. Conclusions Advanced machine learning/classification algorithms produce more accurate personalized predictions of rehabilitation outcomes than commonly used general linear models.

scholarly journals Constraint-Induced Movement Therapy (CIMT): Current Perspectives and Future Directions

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Aimee P. Reiss ◽  
Steven L. Wolf ◽  
Elizabeth A. Hammel ◽  
Erin L. McLeod ◽  
Erin A. Williams
Keyword(s):  
Comparative Study ◽  
Upper Extremity ◽  
Movement Therapy ◽  
Practical Approach ◽  
Treatment Technique ◽  
Review Of Literature ◽  
Substantial Evidence ◽  
Future Directions ◽  
Constraint Induced Movement Therapy ◽  
Upper Extremity Rehabilitation

Constraint-induced movement therapy (CIMT) has gained considerable popularity as a treatment technique for upper extremity rehabilitation among patients with mild-to-moderate stroke. While substantial evidence has emerged to support its applicability, issues remain unanswered regarding the best and most practical approach. Following the establishment of what can be called the “signature” CIMT approach characterized by intense clinic/laboratory-based practice, several distributed forms of training, collectively known as modified constraint therapy (mCIMT), have emerged. There is a need to examine the strengths and limitations of such approaches, and based upon such information, develop the components of a study that would compare the signature approach to the best elements of mCIMT, referred to here as “alternative” CIMT. Based upon a PEDro review of literature, limitations in mCIMT studies for meeting criteria were identified and discussed. A suggestion for a “first effort” at a comparative study that would both address such limitations while taking practical considerations into account is provided.

scholarly journals Revisiting Constraint-Induced Movement Therapy: Are We Too Smitten With the Mitten? Is All Nonuse “Learned”? and Other Quandaries

2007 ◽  
Vol 87 (9) ◽  
pp. 1212-1223 ◽  
Author(s):  
Steven L Wolf
Keyword(s):  
Upper Extremity ◽  
Movement Therapy ◽  
Detailed Model ◽  
Constraint Induced Movement Therapy ◽  
Scientific Exploration ◽  
Critical Issues ◽  
Valuable Treatment ◽  
Impaired Limb ◽  
Task Practice ◽  
Task Oriented

Constraint-induced movement therapy (CIMT) has gained considerable popularity as a valuable treatment for a hemiparetic upper extremity. This approach is compatible with the emerging notion that task-oriented or functionally oriented retraining of the impaired limb provides evidence to support its utility. This article first provides a historical perspective on the development of CIMT. An overview model of how learned nonuse of the hemiparetic limb occurs and can be overcome with CIMT is discussed, and then a more detailed model that incorporates critical issues requiring considerably more basic and applied scientific exploration is described. Among the issues considered are the extent to which hemiparetic limb nonuse and subsequent modes of delivery to overcome it are governed by structure-function deficits rather than being attributable primarily to behavioral phenomena; the relative importance of the intensity of training; the need to better balance unimanual and bimanual upper-extremity task practice; the role of psychosocial and cultural factors in fostering patient compliance; the optimization of modes of delivery; and the reevaluation of the constellation of components contributing to successful outcomes with this treatment. Finally, the strengths, uncertainties, and limitations associated with CIMT are examined.

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