Constraint Induced Movement Therapy (CIMT)

What is CIMT? (Also called CI Therapy or CIT)

Constraint Induced Movement Therapy (CIMT) is a group of therapies designed to restrain the use of the unaffected upper extremity and encourage the use of the affected upper extremity through practice. It involves "constraining" the patient's unaffected arm using a removable cast or sling. This creates an environment for the patient to use his/her affected arm in a variety of fun and therapeutic activities under the guidance of experienced pediatric occupational and physical therapists.

CIMT is based on a model for development of learned nonuse in adults. Immediately after a stroke or injury there are unsuccessful motor attempts by the patient to use the affected limb. Due to pain, failure, or lack of coordination, compensatory movements and behavior patterns are positively reinforced. A person “learns” to not use their affected hand.

Children with hemiplegic cerebral palsy (CP) may also experience learned nonuse of the affected extremity due to the inefficient movement patterns of the involved upper extremity. Increased central nervous system plasticity that is present in children could be the basis for rehabilitation.

Recent research studies are showing that children with CP who participate in constraint induced movement therapy for 3 hours per day for 3 weeks have demonstrated functional improvements in their hemiplegic arm. Results are showing that functional gains can last up to a year and some claim gains to be permanent.  The efficacy may depend on the severity of hand impairment and perhaps attention span.   Further studies are being conducted to determine the most effective age to administer it, as well as the most beneficial amount and frequency of treatment.

In addition, evidence suggests that while CI therapy may improve impaired hand function in some children with hemiplegic CP, these children have impairments in bimanual coordination beyond their unilateral impairments. In order for the child to have functional independence during activities of daily living, the use of both hands in cooperation is needed.

Camp Bennett was developed to provide a program for hemiplegic children to develop these skills through CIMT.  This intensive therapeutic camp will start with 6 hours per day of constraint the first week, then slowly reduce the time of constraint to allow ample time for the child to work on bimanual activities.