View source for STROKE-CONSTRAINT INDUCED MOVEMENT THERAPY (CIMT)

===== [[Summary Article|'''SUMMARY''']] =====
1. CIMT has been shown to produce significant improvements in arm motor function that persist &gt; 1 year (EXCITE Trial, Wolf et al., 2006).
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<br/>2. CIMT requires that patients be able to extend their wrists, actively move their digits &amp; follow instructions.
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<br/>3. In the EXCITE trial, participants were required to have at least 20<sup>o</sup> of active wrist extension, at least 10<sup>o</sup> of thumb abduction/extension, and at least 10<sup>o</sup> of extension in at least two additional digits, with minimal sensory or cognitive deficits:
<br/>- Traditional CIMT: 2 week training program with 6 hours of intensive training with restraint of the normal side for at least 90% of waking hours
<br/>- Modified CIMT: variable intensity, time of constraint and duration of program, stronger evidence of benefit than traditional therapy
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<br/>4. Flannel test for suitability for CIMT: ask the patient to pick up and drop a piece of cloth!
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<br/><i>TIMING OF THERAPY</i>
<br/>5. Traditional CIMT in the acute/subacute phase may be beneficial for improving spasticty and muscle strength, but not motor function. The literature is mixed regarding improvement on ADLs and dexterity.
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<br/>6. Modified CIMT in the acute/subacute phase is beneficial for improving motor function, not be beneficial imporving ADLs, dexterity, spasticity, proprioception or muscle strength.
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<br/>7. Traditional &amp; modified CIMT may be beneficial for imporving motor function, ADLs and muscle strength in the chronic phase following stroke.


==Reference(s)==
Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. [https://amzn.to/3YHrI6K Get it on Amazon.]
<br/>Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. [https://amzn.to/3k7WSW0 Get it on Amazon.]
<br/>Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
<br/>Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].

[[Category:Stroke]]
[[Category:Neurology]]
[[Category:Medicine]]