Constraint Induced Movement Therapy Aided by ArmTutor

Linda Nordstrand, Mominul Islam, Ann-Christin Eliasson of the Karolinska Institutet, Sweden discuss CIMT.
Adolescents with unilateral cerebral palsy are known to have improved hand function immediately after an intensive period of Constraint Induced Movement Therapy (CIMT), but the long-time effect of CIMT on development of hand function is not well known.
The aim  of their research is to  follow-up and describe the development of hand function in adolescents with unilateral cerebral palsy, who had only one episode of CIMT within a six year period.
The result of their research was that the assessment measuring the use and dexterity were stable and the grip strength had increased, while there was a trend towards decreasing quality of movements.
The conclusion they reached was that the adolescents have continued to use their assisting hand, shown by stable hand use and increased grip strength even though the quality of movements seem to have decreased.
 Constraint induced movement therapy (CIMT) is a unique treatment approach used for rehabilitation of the upper limb (arm/hand) following neurological damage. After a neurological event such as a stroke it is common for people to develop a tendency not to use their weaker arm which can lead to learned non-use or in some cases neglect of the weaker arm. CIMT aims to increase the amount of use and quality of movement of the weaker arm by following a structured treatment program developed by researchers in the USA.
The treatment program works by producing ‘rewiring’ of the brain; this means that a larger part of the brain becomes active when producing movement of the weaker arm. This program is underpinned by several research studies which have proven benefits, particularly for stroke patients.
The program involves a number of components in particular the use of repetitive task-oriented training. This involves the person practicing a series of short tasks with the weaker arm for several hours a day over a two to three week period under supervision by a trained therapist. Whilst using the weaker arm the unaffected side is restrained, for example by wearing a mitt or glove to continually remind the person to use the weaker arm.
The person is encouraged to use the weaker arm outside of the treatment program for functional tasks at home whilst wearing the glove or mitt and is provided with a series of home assignments to complete. Research has proven that such intensive and repetitive use of the weaker arm over this short period leads to increased use of the weaker arm as well as improved quality of movement.
The HandTutor has been in the forefront of therapy tools for CIMT in rehabilitation.
The HandTutor™ system, which includes the ArmTutor, LegTutor and 3DTutor, is an active exercise based hand rehabilitation program that uses the accepted methods of impairment oriented training (IOT) with augmented feedback. The HandTutor™ evaluates and treats finger and hand movement dysfunction through exercises that encourage extension/ flexion of the finger(s) and wrist.
The HandTutor™ system consists of a safe comfortable glove, with position and speed sensors that precisely record finger and wrist motion, and dedicated rehabilitation software. The ergonomic gloves come in five sizes for both right and left hands. The rehabilitation system employs the known concept of biofeedback to give occupational and physical therapists access to an affordable user friendly hand rehabilitation package. The HandTutor™ can also be used in combination with the 3DTutor™ for arm rehabilitation. The HandTutor™ is CE medical and FDA certified. See for more information.

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