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What is Constraint Induced Movement Therapy?
Constraint Induced Movement Therapy (CIMT) is constraint of the unaffected or ‘good’ upper limb in order to encourage use of the affected or ‘bad’ arm and hand. It is an evidence based treatment technique used by physiotherapists when a child tends favours use of one hand. This is often due to a neurological condition such as hemiplegic cerebral palsy or stroke. At Physio.co.uk, our neurological physiotherapists are specialists in the safe and effective delivery of CIMT. Research shows that CIMT significantly increases function and muscle strength in the affected upper limb, particularly in those adults and children who are motivated to improve and have some active movement.
Above: Using directed play to promote functional ability in impaired limbsHow does Constraint Induced Movement Therapy work?
CIMT works by constraining the unaffected ‘good’ upper limb using a mitt or sling and the child completing a series of timed, challenging gross and fine motor activities with the affected or ‘bad’ hand under close supervision. By forcing use of the affected hand, your child can overcome leaned non-use. Learned non-use is the result of using the stronger arm to compensate for the weaker arm. It is important that your child already has some active movement in the weaker arm as they will be asked to complete a circuit of activities such as stacking wooden blocks, finding marbles buried in sand or turning over playing cards. These tasks are supervised by a specialist physiotherapist in order to facilitate a normal movement pattern of the arm to prevent pain and muscle imbalance. In order to make substantial benefits from CIMT you will be shown how to continue CIMT with your child at home. Research shows that several hours of this repetitive task intensive therapy will improve function and movement based on the latest evidence of neuroplasticity. Neuroplasticity is the brain’s ability to rewire and adapt as a result of repetitive use of the affected upper limb. As the brain grows new pathways for the nerve signals, your child re-learns how to use the arm and hand and increases its use during normal daily activities.
Above: Equalising the development of fine motor skills by constraining the dominant limb and engaging with structured playPhysiotherapy and Constraint Induced Movement Therapy for children
In order to achieve the best possible function of the arm and hand, it is necessary to constrain the affected upper limb as much as possible while your child is awake and carry out maximum repetitive task practice. At Physio.co.uk, our physiotherapists realise this can be very frustrating for you and your child and will discuss all aspects of CIMT with you both thoroughly before producing a treatment plan that is both practical and achievable.
If you and your child can adhere to the intensive CIMT schedule, there are significant benefits in the short and long term. These benefits include:
- Increased functional use of the upper limb and hand
- Increased muscle strength of the upper limb and hand
- Increased awareness of the position and potential of the upper limb
- Increased independence using the upper limb
- Improved quality of movement
- Improved muscle tone
- Improved quality of life
If your child is a suitable candidate for CIMT your physiotherapist at Physio.co.uk will prescribe an appropriate treatment plan to last 10 or 15 days over 2 or 3 weeks. Your child will receive task intensive physiotherapy sessions at one of our clinic locations for up to 3 hours each day. At home, it is important that your child wears the constraint device on the unaffected upper limb as much as possible. Our physiotherapists will recommend specific time frames and provide a home diary to record the amount of time spent wearing the device each day.
Following completion of our CIMT programme, your child’s range of movement, muscle strength, proprioception, tone and co-ordination will be re-assessed and your physiotherapist will provide objective evidence of your child’s recovery. At this point, further recommendations for physiotherapy or equipment will be provided.
Above: Specialist paediatric physiotherapy led functional exercise programme through playWhy Physio.co.uk for Constraint Induced Movement Therapy for your child?
At Physio.co.uk we understand that you and your child would like full functional use of both arms and hands. CIMT is a new and innovative treatment approach that is rarely used in NHS services due to the intensive nature of the therapy. However, at Physio.co.uk we recognise the building evidence in support of CIMT and are able to provide an excellent standard of CIMT in one of our clinic locations. Our experienced specialist physiotherapists at Physio.co.uk are specifically trained in tailoring a safe and effective CIMT treatment package to suit you and your family.
- Specialist physiotherapists with experience of CIMT
- Motivated, dynamic physiotherapists keen to make treatment enjoyable for your child
- Up to date with the latest evidence based treatments for your child
- Provision of equipment and home CIMT program
- Use of outcome measures to keep a record of improvements made
- Proven track record
- No waiting lists
- CIMT at home or in the clinic
Above: Functional exercises through play with the dominant limb constrained to promote use of the weaker side.Constraint induced movement therapy can be provided in your home or at one of our clinic locations that is convenient for you. If you would like to find out more about how CIMT could work for your child or to book a screening assessment please contact us now on 0330 088 7800.
