The Process
CI therapy for the arm mainly involves intensively training the weaker arm while at the same time preventing use of the stronger arm after a stroke or traumatic brain injury (TBI) by placing it in a mitt for 90% of waking hours over two or three weeks (depending on the severity of the impairment in movement).
Why It Works
The treatment is thought to work because it overcomes a strong tendency not to use the weaker arm (“learned nonuse”) that develops early after stroke or TBI. In addition, CI therapy produces a large "rewiring" of the brain; that is, after treatment, more of the brain works to move the weaker arm than before therapy.
Over 500 patients with stroke and TBI have been treated by several laboratories in many different countries that are associated with this laboratory. About 300 patients have been treated at this institution. They have had mild to moderately severe stroke or TBI (as is true for the majority of stroke or TBI patients). Most of these patients have improved substantially in their ability to use their weaker arm or leg in the activities of daily living at home.
Staying with the Program
Participation in the project requires a good deal of self-discipline. A practice program to be carried out at home is provided for each participant to complete while they are enrolled in treatment in addition to their work in the laboratory. Participants must be willing to work diligently during the daily therapy sessions in the laboratory as well as away from the laboratory.
Failure to comply with project guidelines will reduce the effectiveness of the therapy. Those who have improved the most worked with the program daily and followed all project instructions.
Other Uses for CI Therapy
CI therapy techniques have been extended to treat:
- The leg in individuals with stroke, spinal cord injury, or fractured hip
- The arm in young children with cerebral palsy
- The arm or leg after traumatic brain injury
- Incoordination of the fingers in musicians with focal hand dystonia
- Language in patients with aphasia after stroke