Can constraint-induced movement therapy (CIMT) for cerebral palsy improve arm and hand mobility?
This article will explain what CIMT is, how it can benefit individuals with cerebral palsy, and whether it’s worth trying. Let’s get started!
What is Constraint-Induced Movement Therapy?
Constraint-induced movement therapy is a practice used by occupational and physical therapists to promote upper-limb functions in people with neurological motor disabilities like cerebral palsy.
It involves 2 key components:
First, the unaffected arm must be restrained using a splint, glove, mitt, cast, or sling. This will discourage use of the dominant arm.
Second, the affected arm must undergo intensive therapy to learn how to move and function correctly.
By forcing use of the weaker arm, you’re stimulating the brain to strengthen those movements. Generally, this treatment is extensive, and individuals are encouraged to use only their affected arm for the majority of the day to achieve the best results.
Constraint-Induced Movement Therapy for Cerebral Palsy
Constraint-induced movement therapy isn’t ideal for all individuals with cerebral palsy.
CP is caused by damage to the developing brain. Depending on the location and severity of the damage, different areas of the body can be affected.
For example, some people have motor impairments primarily in their legs (diplegia), while others may be affected in one side of their body (hemiplegia), in one limb (monoplegia), or all over (quadriplegia).
Constraint-induced movement therapy is ideal for those with hemiplegia or monoplegia, when only one arm has motor impairments. Additionally, the individually undergoing CIMT should be motivated to improve, as the intensity of many CIMT programs can be challenging and tiring.
Although CIMT has been mainly utilized in treating individuals with affected arm or hand movements, there is a possibility that it could also help improve leg functions in individuals with hemiplegia.
Research on CIMT for improved leg function has mainly focused on individuals following stroke, however many of the same principles could carry over to its use with children with cerebral palsy. Ask your therapist for more information.
Constraint-induced movement therapy works because it implements the fundamentals of neuroplasticity.
Neuroplasticity is the brain’s ability to rewire itself that allows functions affected by brain damage to be improved or recovered.
The best way to promote neuroplasticity is to perform task-specific, high-repetition movements (which is exactly what constraint-induced movement therapy does!).
CIMT focuses on improving arm and hand functions through functional exercises that require you to continuously use your affected arm.
The more you practice using your affected arm, the more neural rewiring and strengthening occur.
The stronger neural pathways for a movement become, the more intuitive the movement feels. Ideally, accurate movements with the affected arm and hand would become second-nature and no longer require much extra effort or concentration.
Activities You Might Practice During Constraint-Induced Movement Therapy
Some tasks you might practice during constraint-induced movement therapy for cerebral palsy include:
- picking up small items
- pushing buttons
- turning a doorknob
- throwing a ball
Practicing these practical, everyday tasks can help improve functions in your affected arm and hand.
Why Are Therapies like CIMT Necessary?
Luckily, individuals with hemiplegic or monoplegic cerebral palsy will have normal upper-limb functions on one side.
However, this can result in developmental disregard (when children develop a habit of not using their affected arm), which causes the neglected arm to get even weaker and less functional.
Even if the affected arm has very mild motor impairments, most children with hemiplegia will favor and use the unaffected arm while disregarding the affected one.
Being able to use only one arm can make it very challenging to perform activities of daily living independently and contribute to the development of abnormal movements or musculoskeletal deformities.
Children who grow up relying solely on their unaffected arm will likely find CIMT difficult and uncomfortable because they never learned how to use their affected arm.
Understanding Constraint-Induced Movement Therapy and Cerebral Palsy
Is constraint-induced movement therapy the best way to boost arm and hand functions?
While it can be a very effective way to improve hand functions, constraint-induced movement therapy is not the only approach that optimizes neuroplasticity.
Ultimately, the best results are going to come from how many repetitions of affected movements you perform. So find what motivates you and keep practicing!
If you don’t know where to start, consider Flint Rehab’s MusicGlove.
It combines music, gaming, and hand exercises to create a fun and engaging hand therapy experience.
MusicGlove is also clinically proven to boost hand functions in just 2 weeks!
That’s a wrap! Hopefully, this article helped you understand how constraint-induced movement therapy can help individuals with CP improve their hand and arm mobility.
Featured image: ©iStock.com/Jovanmandic/wavebreakmedia/shironosov