The use of constraint-induced movement therapy (CI therapy) to promote motor recovery following stroke

Chapter

Abstract

  • © Cambridge University Press 2008. Stroke is the third leading cause of death, with high economic costs. There are a limited number of experimentally verified therapeutic interventions to enhance motor performance; however, there is a growing body of evidence to support the benefit of constraint-induced (CI) therapy. This chapter details the individual components of CI therapy techniques. Stroke is the third leading cause of death after heart disease and cancer and a leading cause of serious, long-term disability. Profoundly impaired motor dysfunction is a major consequence of stroke (American Heart Association, 2005). As a result, a large number of the more than 700 000 people in America sustaining a stroke each year have limitations in motor ability and compromised quality of life. From the early 1970s to the early 1990s, the estimated number of noninstitutionalized survivors of stroke increased from 1.5 million to 2.4 million (Centers for Disease Control and Prevention, 2004). Medicare spent $3.6 billion in 1998 on stroke survivors discharged from short-stay hospitals. The American Heart Association estimates that the current direct and indirect costs of stroke are $43.3 billion per year. The great prevalence of stroke and its high economic costs make the reduction of stroke-related disability a national healthcare priority. Unfortunately, the number of therapeutic interventions shown in controlled experiments to enhance motor function and promote independent use of an impaired upper extremity (UE) following stroke is quite limited (Duncan, 1997). In our past work, derived from basic research with animals and human subjects, we have developed a set of techniques that reduce the incapacitating movement deficits of many persons in the chronic phase of stroke recovery and increase their independence. The techniques, termed Constraint-Induced Movement therapy or CI therapy, involve a variety of procedures that promote repetitive use of the more-impaired upper extremity (UE) for many hours a day, in the research laboratory, clinical and home settings, during the intervention period (Morris et al., 1997; Morris & Taub, 2001; Taub et al., 1993, 1999; Uswatte & Taub, 2005).
  • Authors

    Digital Object Identifier (doi)

    International Standard Book Number (isbn) 13

  • 9780521691857
  • Start Page

  • 401
  • End Page

  • 416