Skip to main content

Constraint Induced Therapy

  • Reference work entry
  • First Online:
  • 201 Accesses

Definition

Constraint induced therapy (CIT), or more commonly termed constraint induced movement therapy (CIMT), is a neurorehabilitation technique used primarily following stroke, in order to improve functional use of the neurologically weaker upper extremity (Etoom et al. 2016; Fritz et al. 2012; Taub and Uswatte 2006). CIMT typically involves the restraint of an unaffected upper extremity combined with intensive practice with the affected extremity (Kwakkel et al. 2015; Taub and Uswatte 2006). There are a number of excellent reviews and meta-analyses that have recently been published (see “References”).

Historical Background

CIMT was first documented in 1909 by Munk in nonhuman primates (Munk 1909, as cited in Kwakkel et al. 2015). It was observed that animals avoided use of their affected limb unless the unaffected limb was restrained (Fritz et al. 2012; Taub and Uswatte 2006). This idea was then applied to patients with hemiplegia following stroke (Taub and Uswatte 2006)....

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   899.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   1,099.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  • Arya, K. N., Pandian, S., Verma, R., & Garg, R. K. (2011). Movement therapy induced neural reorganization and motor recovery in stroke: A review. Journal of Bodywork and Movement Therapies, 15(4), 528–537. https://doi.org/10.1016/j.jbmt.2011.01.023.

    Article  PubMed  Google Scholar 

  • Barzel, A., Ketels, G., Stark, A., Tetzlaff, B., Daubmann, A., Wegscheider, K., …, & Scherer, M. (2015). Home-based constraint-induced movement therapy for patients with upper limb dysfunction after stroke (HOMECIMT): A cluster-randomised, controlled trial. The Lancet Neurology, 14(9), 893–902. https://doi.org/10.1016/S1474-4422(15)00147-7.

    Article  PubMed  Google Scholar 

  • Berque, P., Gray, H., & McFadyen, A. (2013). A combination of constraint-induced therapy and motor control retraining in the treatment of focal hand dystonia in musicians: A long-term follow-up study. Medical Problems of Performing Artists, 28(1), 33–46.

    PubMed  Google Scholar 

  • Buma, F., Kwakkel, G., & Ramsey, N. (2013). Understanding upper limb recovery after stroke. Restorative Neurology and Neuroscience, 31(6), 707–722. https://doi.org/10.3233/RNN-130332.

    Article  PubMed  Google Scholar 

  • Case-Smith, J., DeLuca, S. C., Stevenson, R., & Ramey, S. L. (2012). Multicenter randomized controlled trial of pediatric constraint-induced movement therapy: 6-month follow-up. The American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association, 66(1), 15–23.

    Article  Google Scholar 

  • Cimolin, V., Beretta, E., Piccinini, L., Turconi, A. C., Locatelli, F., Galli, M., & Strazzer, S. (2012). Constraint-induced movement therapy for children with hemiplegia after traumatic brain injury: A quantitative study. The Journal of Head Trauma Rehabilitation, 27(3), 177–187. https://doi.org/10.1097/HTR.0b013e3182172276.

    Article  PubMed  Google Scholar 

  • Corbetta, D., Sirtori, V., Castellini, G., Moja, L., & Gatti, R. (2015). Constraint-induced movement therapy for upper extremities in people with stroke. The Cochrane Database of Systematic Reviews, (10):CD004433. https://doi.org/10.1002/14651858.CD004433.pub3.

  • Etoom, M., Hawamdeh, M., Hawamdeh, Z., Alwardat, M., Giordani, L., Bacciu, S., …, & Foti, C. (2016). Constraint-induced movement therapy as a rehabilitation intervention for upper extremity in stroke patients: Systematic review and meta-analysis. International Journal of Rehabilitation Research. Internationale Zeitschrift Fur Rehabilitationsforschung.Revue Internationale De Recherches De Readaptation, 39(3), 197–210. https://doi.org/10.1097/MRR.0000000000000169.

    Article  PubMed  Google Scholar 

  • Fritz, S. L., Butts, R. J., & Wolf, S. L. (2012). Constraint-induced movement therapy: From history to plasticity. Expert Review of Neurotherapeutics, 12(2), 191–198. https://doi.org/10.1586/ern.11.201.

    Article  PubMed  Google Scholar 

  • Gillick, B., Menk, J., Mueller, B., Meekins, G., Krach, L. E., Feyma, T., & Rudser, K. (2015). Synergistic effect of combined transcranial direct current stimulation/constraint-induced movement therapy in children and young adults with hemiparesis: study protocol. Bio Med Central Pediatrics, 15(1), 178. https://doi.org/0.1186/s12887-015-0498-1.

    Google Scholar 

  • Hatem, S. M., Saussez, G., Della Faille, M., Prist, V., Zhang, X., Dispa, D., & Bleyenheuft, Y. (2016). Rehabilitation of motor function after stroke: A multiple systematic review focused on techniques to stimulate upper extremity recovery. Frontiers in Human Neuroscience. https://doi.org/10.3389/fnhum.2016.00442.

    Article  PubMed  PubMed Central  Google Scholar 

  • Henderson, C. A., & Manns, P. J. (2012). Group modified constraint-induced movement therapy (mCIMT) in a clinical setting. Disability and Rehabilitation, 34(25), 2177–2183. https://doi.org/10.3109/09638288.2012.673686.

    Article  PubMed  Google Scholar 

  • van Kordelaar, J., van Wegen, E. E., Nijland, R. H., Daffertshofer, A., & Kwakkel, G. (2013). Understanding adaptive motor control of the paretic upper limb early poststroke: The EXPLICIT-stroke program. Neurorehabilitation and Neural Repair, 27(9), 854–863. https://doi.org/10.1177/1545968313496327.

    Article  PubMed  Google Scholar 

  • Kwakkel, G., Veerbeek, J. M., van Wegen, E. E., & Wolf, S. L. (2015). Constraint-induced movement therapy after stroke. The Lancet Neurology, 14(2), 224–234. https://doi.org/10.1016/S1474-4422(14)70160-7.

    Article  PubMed  PubMed Central  Google Scholar 

  • Laible, M., Grieshammer, S., Seidel, G., Rijntjes, M., Weiller, C., & Hamzei, F. (2012). Association of activity changes in the primary sensory cortex with successful motor rehabilitation of the hand following stroke. Neurorehabilitation and Neural Repair, 26(7), 881–888. https://doi.org/10.1177/1545968312437939.

    Article  PubMed  Google Scholar 

  • Lang, K. C., Thompson, P. A., & Wolf, S. L. (2013). The EXCITE trial: Reacquiring upper-extremity task performance with early versus late delivery of constraint therapy. Neurorehabilitation and Neural Repair, 27(7), 654–663. https://doi.org/10.1177/1545968313481281.

    Article  PubMed  Google Scholar 

  • Mark, V. W., Taub, E., Bashir, K., Uswatte, G., Delgado, A., Bowman, M. H., …, & Cutter, G. R. (2008). Constraint-induced movement therapy can improve hemiparetic progressive multiple sclerosis. Preliminary findings. Multiple Sclerosis (Houndmills, Basingstoke, England), 14(7), 992–994. https://doi.org/10.1177/1352458508090223.

    Article  PubMed  Google Scholar 

  • Mark, V. W., Taub, E., Uswatte, G., Bashir, K., Cutter, G. R., Bryson, C. C., …, & Bowman, M. H. (2013). Constraint-induced movement therapy for the lower extremities in multiple sclerosis: Case series with 4-year follow-up. Archives of Physical Medicine and Rehabilitation, 94(4), 753–760. https://doi.org/10.1016/j.apmr.2012.09.032.

    Article  PubMed  Google Scholar 

  • Morris, D. M., Taub, E., & Mark, V. W. (2006). Constraint-induced movement therapy: Characterizing the intervention protocol. Europa Medicophysica, 42(3), 257–268.

    PubMed  Google Scholar 

  • Nijland, R. H., van Wegen, E. E., Harmeling-van der Wel, B. C., Kwakkel, G., & EPOS Investigators. (2010). Presence of finger extension and shoulder abduction within 72 hours after stroke predicts functional recovery: Early prediction of functional outcome after stroke: The EPOS cohort study. Stroke, 41(4), 745–750. https://doi.org/10.1161/STROKEAHA.109.572065.

    Article  PubMed  Google Scholar 

  • Park, J., Lee, N., Cho, Y., & Yang, Y. (2015). Modified constraint-induced movement therapy for clients with chronic stroke: Interrupted time series (ITS) design. Journal of Physical Therapy Science, 27(3), 963–966. https://doi.org/10.1589/jpts.27.963.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rocha, S., Silva, E., Foerster, A., Wiesiolek, C., Chagas, A. P., Machado, G., …, & Monte-Silva, K. (2016). The impact of transcranial direct current stimulation (tDCS) combined with modified constraint-induced movement therapy (mCIMT) on upper limb function in chronic stroke: A double-blind randomized controlled trial. Disability and Rehabilitation, 38(7), 653–660. https://doi.org/10.3109/09638288.2015.1055382.

    Article  PubMed  Google Scholar 

  • Shaw, S. E., Morris, D. M., Uswatte, G., McKay, S., Meythaler, J. M., & Taub, E. (2005). Constraint-induced movement therapy for recovery of upper-limb function following traumatic brain injury. Journal of Rehabilitation Research and Development, 42(6), 769–778.

    Article  PubMed  Google Scholar 

  • Sterr, A., Szameitat, A., Shen, S., & Freivogel, S. (2006). Application of the CIT concept in the clinical environment: Hurdles, practicalities, and clinical benefits. Cognitive and Behavioral Neurology: Official Journal of the Society for Behavioral and Cognitive Neurology, 19(1), 48–54. https://doi.org/00146965-200603000-00006.

    Google Scholar 

  • Taub, E., & Uswatte, G. (2006). Constraint-induced movement therapy: Answers and questions after two decades of research. NeuroRehabilitation, 21(2), 93–95.

    PubMed  Google Scholar 

  • Taub, E., Griffin, A., Uswatte, G., Gammons, K., Nick, J., & Law, C. R. (2011). Treatment of congenital hemiparesis with pediatric constraint-induced movement therapy. Journal of Child Neurology, 26(9), 1163–1173. https://doi.org/10.1177/0883073811408423.

    Article  PubMed  PubMed Central  Google Scholar 

  • Taub, E., Uswatte, G., Mark, V. W., Morris, D. M., Barman, J., Bowman, M. H., …, & Bishop-McKay, S. (2013). Method for enhancing real-world use of a more affected arm in chronic stroke: Transfer package of constraint-induced movement therapy. Stroke, 44(5), 1383–1388. https://doi.org/10.1161/STROKEAHA.111.000559.

    Article  PubMed  PubMed Central  Google Scholar 

  • Uswatte, G., & Taub, E. (2013). Constraint-induced movement therapy: A method for harnessing neuroplasticity to treat motor disorders. Progress in Brain Research, 207, 379–401. https://doi.org/10.1016/B978-0-444-63327-9.00015-1.

    Article  PubMed  Google Scholar 

  • Woldag, H., Voigt, N., Bley, M., & Hummelsheim, H. (2017). Constraint-induced aphasia therapy in the acute stage: What is the key factor for efficacy? A randomized controlled study. Neurorehabilitation and Neural Repair, 31(1), 72–80. https://doi.org/10.1177/1545968316662707. [pii].

    Article  PubMed  Google Scholar 

  • Wolf, S. L., Thompson, P. A., Winstein, C. J., Miller, J. P., Blanton, S. R., Nichols-Larsen, D. S., …, & Taub, E. (2010). The EXCITE stroke trial: Comparing early and delayed constraint-induced movement therapy. Stroke (00392499), 41(10), 2309–2315. https://doi.org/10.1161/STROKEAHA.110.588723.

    Article  PubMed  PubMed Central  Google Scholar 

  • Zhu, Y., Zhou, C., Liu, Y., Liu, J., Jin, J., Zhang, S., …, & Wu, Y. (2016). Effects of modified constraint-induced movement therapy on the lower extremities in patients with stroke: A pilot study. Disability and Rehabilitation, 38(19), 1893–1899. https://doi.org/10.3109/09638288.2015.1107775.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Marianne Hrabok .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Borza, C., Mrazik, M., Hrabok, M. (2018). Constraint Induced Therapy. In: Kreutzer, J.S., DeLuca, J., Caplan, B. (eds) Encyclopedia of Clinical Neuropsychology. Springer, Cham. https://doi.org/10.1007/978-3-319-57111-9_1087

Download citation

Publish with us

Policies and ethics