Constraint-Induced Movement Therapy

Constraint Induced means induced with pressure or without permission. It is a type rehabilitation that increases activity of the upper extremity. Typically CIMT used to restart the unaffected arm in the patient with cerebral palsy (spastic hemiplegic) for most of the time while involving affected limb in a range of everyday living activity.

CIMT basically a technique applied when the child stops using his affected limb due to its unexpected activities. Child with spastic hemiplegic has less power on one side then other. He just doesn’t use his affected side due to its clumsy response and this neglecting behavior towards affected side make it more and more suppressed in activity. CIMT seeks to reverse this process.

As the result of engaging patient in repetitive activity of the affected limb brain develops new neural pathways. This change referred as cortical reorganization. This CIMT is more important in cerebaral palsy with the child whose one limb is more affected then other.

CIMT may work on the damaged motor network. Although, due to the intensity of this treatment, patient who have suffered profound upper extremity paralysis from their condition are normally not eligible for constraint-induced upper extremity training.

Effect of CIMT is too good. It improves movement not only this improvement remains stable for months. This also increased functional activity of daily living of the affected limb. CIMT includes transfer package in this physiotherapist applies many strategies to make learn the activities outside the clinical setups. This includes first monitoring, needs to documents patients activity towards target behavior second problem solving, in which patient needs to solve problem of obstacles third one is behavior contracting, involves getting identify the components and methods carrying out normal behavior.

There are some limitations of the CIMT. If patient is not cooperative then it’s a great problem in CIMT, as patient is of severely affected. In case of balance problem CIMT process creates problem. In case of global aphasia and cognitive problem, communicating problem may be phased. CIMT technique is intensity based if patient can tolerate this intensity then its good otherwise it creates a problem. Lack of facility is also a great problem faced by patient and therapist. Combination of therapy and CIMT shows better result its unknown till.

Over all CIMT is very beneficial and result giving. So its use is more in hemiplegic childs.

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Dr. Jitendra Kumar Jain