What is Constraint-Induced Movement Therapy?

Constraint-induced movement therapy is a physical therapy technique used to help people recover from strokes and other injuries to the brain and central nervous system. Dr. Edward Taub, a noted behavioral neuroscientist, developed this approach to address the tendency for patients to stop using more seriously affected extremities. The goal is to achieve more physical balance by making patients use their affected extremities intensively for a short period of time to develop greater confidence and dexterity. This therapy is available at physical therapy centers all over the world and sessions can last between two and three weeks.

Typically, constraint-induced movement therapy focuses on an arm affected by a brain injury. The patient wears a sling to limit movement of the less affected arm. In physical therapy sessions lasting between three and six hours a day, the patient works on repetitive tasks with the therapist, working the affected arm to develop greater strength and manual dexterity. This can also increase confidence, helping patients overcome fears of spilling and dropping things.

The therapy includes homework, tasks the patient performs at home during the course of therapy. The patient must keep an activity diary and report to the therapist regularly. As patients identify weak points in their daily routines, the therapist works with the patient to help overcome them. For example, if a patient confesses to using the stronger arm to prepare tea in the morning, the therapist will work with the patient on the movements while in sessions so the patient can go home and practice, using the weaker arm until she has more confidence.

In constraint-induced movement therapy, the patient must use the weaker arm because the stronger arm is not available, and must regularly solve problems to figure out how to complete tasks with the more seriously injured limb. In addition to developing skills in the arm, this can also help remap pathways in the brain. It may restore function to a higher degree than conventional physical therapy and can help patients feel more active and confident in daily life.

This therapy is intensive and can be exhausting for patients. Many patients also express feelings of frustration and irritation with the process. Home support can include pushing patients to use their weaker limbs even when they do not want to, and this can create resentment. Patients may find it helpful to have rotating assistance from family members during constraint-induced movement therapy, and sometimes traveling for constraint-induced movement therapy helps by taking patients out of their home environment and allowing them to adjust in an unfamiliar place where their old habits are not as easy to follow.