CIMT
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Constraint-Induced Movement Therapy
Theoretical Basis of the Technique
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Rationale
CIMT encompasses perspectives from neuroplasticity and behavioral therapy. Two mechanisms have been proposed to explain the basis of increased use of affected upper extremity:
1. Overcoming learned non-use of affected arm
The learned non-use theory asserts that when motor attempts of the affected extremity, after brain injury, yield unsuccessful results (i.e. pain, incoordination, failure to meet movement goal) will lead to compensatory behavior that results in use of non-affected extremity for positive reinforcement.
Effects of CIMT: CIMT aims to counter this learned non-use effect by restraining the functional limb and forcing the affected arm to complete concentrated and repetitive movements. Forced use of affected arm leads to reduction of the reinforcement of the use of the functional arm.
2. Induction of use-dependent cortical organization
After stroke or brain injury, functional magnetic resonance imaging (fMRI) have revealed that cortical reorganization occurs post stroke. fMRI has also shown that these cortical organizations changes after recovery from stroke and therapeutic intervention.
Cortical Neuroimaging and transcranial magnet stimulation studies of the brain have shown changes in brain activity, specifically in the motor cortex, after the first week of task-oriented training from CIMT.
(Hrabok & Kerns, 2013)