ABSTRACT

Constraint induced movement therapy(CIMT) is intense in that patient’s unaffected arms are re-strained for 90% of waking hours during a two-week period while they also participate in activity sessions using the affected arm for 6 hours/day on 10 consecutive weekdays. CIMT trials has been used for the upper limb of patients with chronic and subacute CVA and patients with chronic trau-matic brain injury and for the lower limb of patients with CVA, incomplete SCI, fractured hip and focal hand dystonia of musicians. The mostly, Action Research Arm Test(ARA), Wolf Motor Function Test(WMFT), Motor Activity Log(MAL), a number of neuroimaging and transcranial magnetic stimulation studies have shown that the massed practice of CIMT is effective. Although efficacious, CIMT may be difficult to implement. A recently, Modified CIMT protocol has been de-veloped that combines structured, 1/2 hour, functional treatment sessions(occupational therapy, physical therapy) with restriction of the unaffected upper limb 5d/wk for 5 hours, both during a 10 week period. It establishes a bridge between the clinic and the life setting so that the therapeutic gains made in the clinic transfer to the functional independence of the patient in the real world.