Constraint Induced Movement Therapy (CIMT)

CIMT: What is it?

Here at One Step Ahead Mobility, we have two CIMT-qualified neurological physiotherapists. In fact, we are one of only a handful of clinics to offer this program in Canada.

Constraint-Induced Movement Therapy (CIMT) is a rehabilitation technique used primarily for stroke survivors or individuals with limited mobility due to conditions like cerebral palsy or traumatic brain injury.

The core principle of CIMT is to constrain the movement of the unaffected limb (usually the stronger limb) while intensively training and encouraging the use of the affected limb. This approach aims to overcome learned non-use, a phenomenon where individuals rely excessively on their less affected limb, leading to neglect or reduced use of the affected one.

How does CIMT work?

Constraint: The unaffected limb is constrained using a mitt, sling, or other devices, preventing its use for a set period. This restriction forces the affected limb to perform everyday tasks.

Intensive Training: During this constraint period, the individual undergoes intensive training and practice using the affected limb. The therapy involves repetitive and functional tasks designed to improve movement, strength, and coordination.

Behavioral Techniques: CIMT often incorporates behavioral techniques to encourage and motivate the use of the affected limb, aiming to break the pattern of non-use. This could involve setting goals, providing positive reinforcement, and promoting self-efficacy.

CIMT is conducted under the supervision of trained therapists and tailored to each person's specific needs and abilities. Research has shown that CIMT can lead to significant improvements in motor function and daily activities for many individuals, especially when combined with other rehabilitation strategies that harness neuroplasticity.

However, CIMT might not be suitable for everyone. Factors like the severity of impairment, cognitive abilities, and overall health can influence its effectiveness.

CIMT for MS

Constraint-Induced Movement Therapy (CIMT) is a rehabilitation approach primarily used in stroke rehabilitation to improve the function of an affected limb. However, it has also been explored in other neurological conditions, including multiple sclerosis (MS), albeit to a lesser extent.

In the context of MS, CIMT may be considered for individuals with significant upper extremity (arm/hand) weakness or impaired motor function. The therapy involves intensive training of the affected limb by restricting the movement of the unaffected limb, usually through the use of a restraining device like a mitt or sling. This restriction encourages the individual to actively use and engage the affected limb in functional activities and exercises.

CIMT typically involves the following components:

Restraint of the Unaffected Limb: The non-affected limb is constrained or immobilized to encourage the use and engagement of the affected limb during daily activities and exercises.

Intensive Task-Specific Training: Individuals undergo structured and repetitive training sessions that focus on functional tasks relevant to their daily life, encouraging active use of the affected limb.

Progressive Training: The therapy progresses in intensity and difficulty as the individual's motor function improves, challenging the affected limb with increasingly complex tasks.

The goal of CIMT is to encourage neuroplastic changes in the brain, facilitating motor recovery and improving the functional use of the affected limb. By promoting repetitive and intensive use of the affected limb, CIMT aims to rewire the brain's neural pathways to enhance motor function.

While there's ongoing research exploring the effectiveness of CIMT in MS, its application in this condition might vary due to the diverse nature of symptoms and the progressive nature of MS compared to stroke. As with any rehabilitation approach, CIMT in MS should be carefully tailored to individual needs, considering factors such as the stage of the disease, severity of motor impairment, and overall functional goals.

Consulting with healthcare professionals experienced in MS rehabilitation can provide insights into whether CIMT might be a suitable option and how it could be integrated into a comprehensive rehabilitation plan.

My CIMT Story

The three-week CIMT sessions were gruelling, but well worth the effort.

For years I had difficulty walking and standing, and the therapist worked diligently to straighten and strengthen my legs. I learned to walk with new equipment. The walking poles and rollator improved my foot placement and increased my speed and balance.

Using my aides, I walked further than I have in a decade. I walked on a treadmill for the first time in 20 years and was surprised at my endurance.

The individual attention and direction from the therapist and the improvement in my skills increased my confidence.

Both the staff and other clients were positive and supportive and motivated me to keep striving.

- Jane F.