Stroke Patients Regain Use of Limbs with a New Therapy

Constraint-Induced (CI) Movement Therapy is a new technique developed by Dr. Taub that assists stroke patients to regain lost limb use. Studies suggest that CI therapy helps patients regain a significant amount of their former mobility beyond what regular physical therapy provides. It is suggested that CI utilizes two neurobehavioral processes:

• Intensive Operant Behavioral Training or "Shaping." Clinicians train patients to use the impaired limb for daily tasks and to resist using the corresponding healthier one. Clinicians model for the patient daily-living tasks and reinforce a patient's progressive improvement, step by step.

• Massive Brain Neuronal Reorganization. Following an injury, patients compensate for loss of use of a limb by increased use of the healthier limb. Consequently, the area of the brain responsible for moving the weaker arm becomes smaller. By forcing exercise on the weaker limb, CI therapy instead teaches the brain to rewire itself by assigning new neurons to moving the weaker limb.

This technique solidifies the growing evidence of the brain's plasticity throughout the life span and eliminates a previous belief that the brain is hardwired. The hardwired perspective assumed that the adult nervous system could not repair or reorganize itself. Unfortunately, this view left millions of patients with chronic stroke with untreated motor deficits. Studies conducted by Taub indicated that CI therapy can increase stroke victims spontaneous use of a compromised limb by 50%; much higher than physical therapy. Such research findings indicate that the central nervous system not only influences behavior, but behavior can equally have a bidirectional influence on the central nervous system. It is hoped that CI therapy can rehabilitate young children with cerebral palsy and other patients with central nervous system disorders.