Constraint-Induced Therapies

Stroke resulting in motor dysfunction can lead to functional impairment and reduced quality of life. Upper extremity involvement may lead to learned nonuse where the individual avoids using the affected limb after repeated failed attempts to incorporate it into functional activities. Constraint induced movement therapy (CIMT) is designed to counteract learned nonuse by limiting reliance on the unaffected upper extremity and structuring activities to promote primary use of the affected side. Numerous CIMT protocols have evolved that vary in duration and intensity; these have been found to impact motor recovery throughout the acute, subacute, and chronic phases post-stroke. However, despite this evidence, CIMT has not been routinely incorporated into clinical care due to barriers, including high resource intensity and time commitment as well as the potential for poor patient tolerance. In response to these concerns, current research explores the efficacy of CIMT when administered in non-traditional settings including group-based interventions and remote therapy programs where supervision is provided most commonly by a family member or other caregiver.