Frequently Asked Questions
What is CIMT
Constraint induced movement therapy ("CI Therapy" or "CIMT") is a specialist form of treatment used in the rehabilitation of the upper limb (hand/arm) following neurological damage. This intensive therapy involves repetitive task practice using the weaker arm whilst the stronger arm is restrained in either a mitt or lightweight removeable cast over a number of weeks. Constraint induced movement therapy has been proven to increase functional use of a childs weaker arm.
How does CIMT work
Constraint induced movement therapy works by helping the person to overcome learned non-use and stimulating the development of new neural connections in the brain. Learned non-use develops as a result of the person learning to compensate for their weakness by using their stronger arm. With CIMT the person is repeatedly using their weaker arm during the treatment programme and as a result they develop more efficient movements and are more likely to use their hand in function.
Who is suitable for CIMT
Adults with neurological weakness primarily affecting one upper limb (hemiplegia) can be considered for constraint induced movement therapy. They must have a certain amount of movement already in the hand in order to participate in the programme. Our specialist CIMT therapists will conduct a screening assessment before anyone undergoes CIMT to ensure they are suitable.
How long does the programme last
If you are suitable for constraint induced movement therapy the programme will last between 2 and 4 weeks depending on the type of programme recommended by the specialist CIMT therapist. Clinic sessions are for 3 hours, 5 days a week.
Where does the programme take place
Our CIMT programmes are carried out in our specialist clinic in Manchester.
How long do I wear the mitt/ cast for
When undergoing constraint induced movement therapy the person wears the mitt or cast on the stronger arm during the treatment sessions and for agreed periods of time at home. Each person will have individual recommendations and a home diary to record time spent wearing the glove/mitt.
For adults the ideal amount of time is 90% of their waking hours throughout the programme, including weekends.
Which programme is best, 2 or 3 weeks?
This often depends on the amount of activity in the arm prior to starting a programme. Generally speaking the longer the programme, the more improvements can be made, however we must take into account an individuals tolerance of prolonged therapy and the logistics of attending a programme.
Your therapist may choose to use some of the programme to focus on bilateral (two handed) tasks towards the end of a programme without using the mitt orcast. A longer programme allows for more time to focus on this, however we still gain significant results from 2 weeks.
How long do the improvements last?
Studies have shown improvements have retained on 6 month and 1 year follow ups. Some children may experience a slight drop in the improvements made over time but this is dependent upon their age, ability and follow-up treatment. See how will CIMT help for more details but generally the more practice you put in at home post CIMT the better the improvements.
How do you measure the improvement
We use a mixture of outcome measures to track the progress throughout the programme, including taking daily videos so that at the end of the programme you can go back and look at the gains and improvements you have achieved. Our specialist therapists are trained to carry out the Fugl Meyer assessment of sensorimotor recovery (FMA) which is a thorough and detailed objective assessment that evaluates hand function and sensation in adults with hemiplegia. The Motor Activity Log is used to measure how well and how often you use your hand in everyday activities. Both of these outcome measures are used at the start of the programme to determine baseline function, and the end of the programme to determine their progress.
What happens at the end of the programme?
Following the completion of the programme, your therapist will produce a detailed report giving an overview of the programme, analysing and explaining the results, and providing recommendations for activities to work on – these could be with their current therapy team or at home. For this, you will be provided with a mitt or removable cast which is made on the last day of the programme.
You will then attend a six-month follow up in one of our clinics where your therapist will re-assess,, make further suggestions on how to progress their therapy, and make a new cast if they have out-grown the one made previously. We encourage all patients to keep in touch with our team, so that we can continue to offer advice on future treatment.
Can our own therapy team at home be trained to continue the work carried out during the programme?
At the end of each programme, our therapists provide extensive recommendations for activities to work on, to continue to progress the patients arm and hand function. We frequently liaise with your own therapy team, whether it be private or NHS, to advise them on how to continue progressing your CIMT treatment and maximise the benefits of the programme.
I’d like to speak with other adults who have tried CIMT. Is this possible?
We encourage patients who are thinking of trying CIMT to speak to other patients who have already experienced one or more programmes with us. We can provide you with details of patients who have a similar condition, with their permission. We also have a Facebook group where potential patients and patients who have tried CIMT can discuss and offer each other support and advice.
Call Our Helpline Today
Call us on 0330 223 0077 or email firstname.lastname@example.org to speak to one of our specialist CIMT therapists.