Adult Referral Criteria

Constraint Induced Movement Therapy (“CI Therapy”, “CIMT”) is suitable for adults with upper limb weakness resulting from neurological damage to the brain or spinal cord.

Our referral criteria is as follows:

• Hemiplegia presentation: Constraint induced movement therapy is designed to overcome learned non-use following a neurological event and is only suitable for patients with one upper limb affected rather than both.
• Some activity in hand and wrist: To take part in a CIMT programme an adult would need a small amount of activity in the hand and wrist. CIMT requires approximately 10 degrees of active wrist and finger extension- this can be from any starting position (eg full flexed).

• At least 6 months after a neurological injury: Our programmes are suitable for people who are at least 6 months post-injury. This is because the programme focuses entirely on the arm and is very intensive – often within the first 6 months there are other difficulties that need to be addressed and fatigue can be a major symptom. After 6 months there is no time limit on when a CIMT programme can take place. Constraint induced movement therapy has achieved the same significant results for adults up to ten years post-stroke! CIMT has also been used in adults who acquired their hemiplegia in childhood.
• No age limit: CIMT has been shown to work effectively for any age, as long as they are able to take part in an intensive programme of treatment.
• Co-morbidities: We can work with adults who have additional complications such as mobility or communication difficulties. The CIMT therapist will determine whether the use of a constraint mitt will impact severely on mobility or cause a safety issue (for example when using a walking aid). Excessive pain or fatigue must be considered when assessing for suitability, but programme structure could be altered to accommodate if required.
• Cognitive ability and motivation: A CIMT programme is intensive and results often depend on patient participation. A patient would need to be able to follow instructions and engage with the therapist, as well as demonstrate a high level of motivation to participate.

Constraint induced movement therapy has been used for adults with a variety of neurological conditions. To find out more information about conditions that CIMT can help, see conditions.

If you are not sure whether CIMT would be suitable for you patient, contact us for a free telephone consultation with one of our specialist therapists who’d be happy to discuss the treatment further with you.