Constraint-induced movement therapy based on behavioral neuroscience.

Abstract

Constraint-induced (CI) movement therapy is a new approach to physical rehabilitation (Taub, 1980) elaborated from basic research in behavioral psychology and neuroscience. It has been shown in controlled experiments to greatly increase the amount of use of an impaired upper extremity in patients with chronic stroke (see Chapter 4, this volume) in both the laboratory (

Constraint-induced movement therapy for recovery of upper-limb function following traumatic brain injury

“…In addition, the Quality of Movement scale was administered to the participants daily during the treatment period. Only the Quality of Movement scale, referred to from here forward as the Arm Use scale, is reported because the Amount of Use scale is highly correlated with the Arm Use scale (i.e., redundant) and less reliable [17][18]40] …”

“…To date, this approach has been used most frequently with persons recovering from stroke and has been observed to produce improvements in motor function and actual amount of use of a more-affected UL in the real-world environment [12][13][14][15][16][17][18][19]. In our laboratory, CI therapy in the past has involved training of the more-affected UL 6 hours daily for 10 consecutive weekdays over a 2-week period (i.e., concentrated practice or repetitive training).…”

“…The MAL is a structured interview in which respondents are asked to rate how much (Amount of Use scale) and how well (Quality of Movement scale) they use their more-affected UL for 30 activities of daily living (ADL) outside the laboratory [12,[17][18]. The MAL was administered independently to participants and one of their caregivers, if one was available.…”

“…Treatment effectiveness was determined in two separate domains: optimal motor ability as evoked on request in laboratory motor tests and actual spontaneous use of the more-affected UL in a real-world setting [17][18]. The laboratory-based measures of motor ability were the FuglMeyer (FM) Motor Performance Assessment [31][32] and the Wolf Motor Function Test (WMFT) [12,[33][34][35].…”

“…The laboratory-based measures of motor ability were the FuglMeyer (FM) Motor Performance Assessment [31][32] and the Wolf Motor Function Test (WMFT) [12,[33][34][35]. The measure of real-world use was the Motor Activity Log (MAL) [12,[17][18]36]. The FM Motor Performance Assessment is an impairment-based laboratory test of motor ability that examines sensation, range of motion, pain, and quality of movement during a series of increasingly difficult motor tasks [31][32].…”