The neural basis of constraint-induced movement therapy

@article{Wittenberg2009TheNB,
  title={The neural basis of constraint-induced movement therapy},
  author={George F. Wittenberg and Judith D. Schaechter},
  journal={Current Opinion in Neurology},
  year={2009},
  volume={22},
  pages={582–588}
}
Purpose of reviewThis review describes our current understanding of the changes in brain function and structure that occur in response to an intensive form of motor rehabilitation, constraint-induced movement therapy (CIMT), that has been shown to be efficacious in promoting motor function of the paretic upper limb of stroke patients. Recent findingsStudies using transcranial magnetic stimulation have demonstrated consistently an increase in the size of the representation of paretic hand… Expand

Paper Mentions

Interventional Clinical Trial
The aim of this randomized controlled trial is to determine the effects of constraint induced movement therapy CIMT and BIM bimanual activities on functional outcome in hemiplegic CP… Expand
ConditionsCerebral Palsy, Congenital
InterventionOther
Change in Movement-Related Cortical Potentials Following Constraint-Induced Movement Therapy (CIMT) After Stroke
Abstract. Patients with chronic stroke were given Constraint-Induced Movement Therapy (CIMT) over an intensive two-week course of treatment. The intervention resulted in a large improvement in use ofExpand
Influence of constraint‐induced movement therapy upon evoked potentials in rats with cerebral infarction
TLDR
The results demonstrate that CIMT can promote recovery of motor function in focal cerebral cortical infarcts, and that recovery may be related to reorganization of the cerebral neuronal network in the somatosensory pathway. Expand
Effects of rehabilitative training on recovery of hand motor function: A review of animal studies
  • N. Higo
  • Psychology, Medicine
  • Neuroscience Research
  • 2014
TLDR
Both functional brain imaging and gene expression analyses suggest that functional and structural changes may occur in undamaged motor areas during recovery of hand function after M1 or corticospinal tract lesions. Expand
Constraint-induced Movement Therapy, Neuroplasticity, and Upper Extremity Motor Recovery after Stroke
TLDR
The role of cortical reorganisation (neural plasticity) in motor recovery of the paretic upper extremity of chronic stroke patients as well as the efficacy of constraintinduced movement therapy in improving upper limb motor function of chronic Stroke patients is explored. Expand
Constraint-induced movement therapy: from history to plasticity
TLDR
The focus is on brain plasticity with an emphasis on the importance of the type and location of stroke and how this factor might influence outcomes following CIMT. Expand
To Move or Not to Move? Functional Role of Ventral Premotor Cortex in Motor Monitoring During Limb Immobilization
TLDR
The present findings highlight the crucial role of vPMC in the anatomo-functional network generating the human motor-awareness, as well as the plastic changes induced by long-lasting immobilization, proved by the cast-related corticospinal excitability modulation in subjects. Expand
Influence of bimanual exercise on muscle activation in post-stroke patients
TLDR
It is suggested that in-phase motion may activate neural circuits that trigger recovery in survivors of post-stroke rehabilitation, and coupling had an effect on behavior, but the response of patients was divided between those whom coupling helped or hindered. Expand
Bilateral versus ipsilesional cortico-subcortical activity patterns in stroke show hemispheric dependence
TLDR
The observed hemispheric-dependent activation/deactivation shifts are novel and these pathophysiological observations suggest short-term neuroplasticity that may be useful for hemisphere-tailored neurorehabilitation. Expand
Long-term limb immobilization modulates inhibition-related electrophysiological brain activity
TLDR
Findings can be interpreted as a consequence of plastic changes induced by immobilization, as also demonstrated by the cast-related corticospinal excitability modulation and by the decreased beta band in response to Go and Nogo trials. Expand
Neuromechanical Principles Underlying Movement Modularity and Their Implications for Rehabilitation
TLDR
It is proposed that motor module organization is disrupted and may be improved by therapy in spinal cord injury, stroke, and Parkinson's disease. Expand
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Even in chronic stroke patients, reduced motor cortex representations of an affected body part can be enlarged and increased in level of excitability by an effective rehabilitation procedure, demonstrating a CNS correlate of therapy-induced recovery of function after nervous system damage in humans. Expand
Alterations in cortical excitability in chronic stroke after constraint-induced movement therapy
TLDR
Changes in cortical electrical excitability while performing both involuntary and voluntary movements after 2 weeks of CIMT in subjects with chronic stroke may be seen as a sign of neural reorganization instigated by the intervention. Expand
Functional Reorganization and Recovery After Constraint-Induced Movement Therapy in Subacute Stroke: Case Reports
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The results suggest that TMS can be safely and effectively used to assess brain function in subacute stroke and further suggest that CIMT may enhance cortical/subcortical motor reorganization and accelerate motor recovery when started within the first two weeks after stroke. Expand
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FMRI data provide preliminary evidence that gains in motor function produced by CIMT in chronic stroke patients may be associated with a shift in laterality of motor cortical activation toward the undamaged hemisphere. Expand
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TLDR
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Remodeling the Brain: Plastic Structural Brain Changes Produced by Different Motor Therapies After Stroke
TLDR
Findings suggest that a previously overlooked type of brain plasticity, structural remodeling of the human brain, is harnessed by constraint-induced movement therapy for a condition once thought to be refractory to treatment: motor deficit in chronic stroke patients. Expand
Constraint-Induced Movement Therapy During Early Stroke Rehabilitation
TLDR
The relationship between changes in motor function and in evoked motor responses suggests that motor recovery during the 1st 3 months after stroke is associated with increased motor excitability of the affected cerebral hemisphere. Expand
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This is the first demonstration in humans of a long-term alteration in brain function associated with a therapy-induced improvement in the rehabilitation of movement after neurological injury. Expand
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