Why use CIMT?
After a unilateral neurological damage, people tend to adapt to the weakness in their affected arm by using their other arm instead because movement on the non-affected side is easier and more efficient. In time, patients tend to stop trying to use their weaker arm as they have learnt to automatically use the non-affected arm. This behaviour often continues even if the weaker arm starts to get stronger. CIMT is designed to break this pattern by encouraging use of the weaker arm.
To break this pattern and allow the use of both hands again, there are some factors that need to be satisfied. CIMT is the only rehabilitative technique that combines all these factors, some of which being restraint of the non-affected side, intensive training of the affected hand on everyday, functional activities and a tailor-made program that matches the specific person’s abilities.
Adult CIMT program
Adult CIMT program is delivered over a 2 or 3 week period (depending mostly on the person’s functional level), while therapy sessions are 5 days a week, with each session lasting 6 hours.
Participants wear a restraining mitt on the non-affected hand for 90% of the waking hours for the full duration of the program, including weekends. The restraint mitt is a lightweight glove, made of perforated fabric that fits on the hand and wrist and allows minimum finger movement. Participants are expected to continue to practice with their affected arm even when outside of the clinic. Home based practice is designed to match each person’s interests and abilities and uses functional tasks, meaning everyday tasks.
CIMT program focuses on transferring acquired skills to everyday environment and thus, works on functional gains that relate to the person’s family life, work and social environment.
Pediatric CIMT program
Pediatric CIMT involves intensive practice with the affected side, while restraining the unaffected side in a light weight cast. The cast has padding inside and covers the hand and arm up until below the shoulder. The cast is worn 24 hours a day, 7 days a week for the full duration, which might be 2 or 3 weeks (depending mostly on the child’s functional level). It is instructed to only be removed by the therapist in order to clean the arm and check for skin integrity. The purpose of the cast is to allow child’s complete focus on the affected side that has been shown to influence brain changes Practice takes place for 3.5 hours daily in the clinic, excluding weekends. Children are expected to continue to practice with their affected arm even when outside of the clinic. Home based practice is designed to match each child’s interests and abilities and uses functional tasks, meaning everyday tasks and play.
Pediatric CIMT program includes a range of children tasks and focuses on transferring acquired skills to everyday environment, such as the child’s home, school and other social environment.