A therapeutic treatment approach that has the capability to considerably improve the functional use of a paralyzed arm for Children and Adults.
What is Constraint Induced Movement Therapy?
CIMT is a program that was developed through the hard work and devotion of the well-known neuroscientist Dr. Edward Taub out of the University of Alabama at Birmingham. His research, which began in the 1970’s and continues to today, has focused on understanding learned non-use, which is a neurological symptom that must be overcome in order to regain function in a paralyzed arm. The end result is a revolutionary therapy program that is based completely on the concept of Neuroplasticity- the ability to change the brain. It truly defines the concept of seeing Neuroplasticity in action. CIMT is a therapy program that teaches the brain how to rewire itself so that a person can regain functional use and confidence in the paralyzed arm.
What is involved in Constraint Induced Movement Therapy (CIMT)?
Adults or Children who are considering the CIMT program will first undergo an evaluation process to ensure that they are candidates for the protocol. Also, initial testing is performed to establish a baseline of function. Medical clearance paperwork is prepared at the evaluation session and must be signed off on by the client’s primary physician prior to starting the program.
The actual one on one therapy sessions in the clinical setting involve active participation on the part of the client, using a variety of techniques that promote repetitive use of the more-affected upper extremity for many hours a day.
A constraint type device is worn on the unaffected arm during the therapy session and during 90% of the hours outside of the clinic. The type of device is chosen based on the safety needs of the individual (i.e. a padded mitt, removable cast, sling, etc). Children are often molded with a removable cast, while adults often wear a padded mitt.
The entire therapy program runs for two straight weeks. The first five days include 3-4 hour therapy sessions that are one on one with a trained therapist. After the first week, a two-day break from the clinic occurs (usually over a weekend) however the client is still required to follow the constraint protocol on those days and wear the constraint device as advised. Five days continue for the second week of 3-4 hour therapy sessions with constraint of the unaffected arm occurring at home throughout.
The adult individual is given home assignments to be completed after each therapy session. The individual also answers questions each day about how well he or she feels the arm functioned during various daily living tasks that he or she is attempting to perform at home. This promotes a mindfulness of the affected limb and is a critical aspect of the program.
For children, the caregiver takes on the role of facilitating use of the involved arm during the two weeks. The treating therapist supports the caregiver in designing play experiences and daily living tasks that promote successful use of the child’s involved arm at home within the child’s normal daily routine that occurs outside of the treatment sessions. Each therapy session, the caregiver provides the feedback on how well the child is doing with certain daily tasks with the affected arm.
How much does CIMT therapy Cost?
CIMT is currently not reimbursed by insurance companies. For adult clients, it may be possible to bill Medicare for a portion of the expense.
The entire two-week program from start to finish costs $6000.00. This includes the follow up phone conferences that occur on a weekly basis for the first month. Monthly phone conferences occur thereafter up to the 6-month mark post-treatment and these are part of the original cost as well.
To be evaluated for the program, the initial evaluation fee is $350.00. This fee is often refundable by insurance companies and our office provides support in assisting clients to seek this return.
Should an adult or child be evaluated for the program but not meet the qualifications for the program, a plan of care will be developed for that individual based on their specific needs, circumstances and personal goals.
Please contact (631) 899-3635 for further information regarding the cost of the program.
Who is a Candidate?
Adults with the following characteristics:
- Have a love for life and themselves and believe in all possibilities
- Alert and Oriented to Person, Place and Time
- Functional Memory
Children with the following characteristics:
- Love to play
- Able to communicate (through any function method)
Candidates for the program who have suffered a stroke must be at least one-year post stroke.
Adults and children looking to enter the program must have some movement in the affected arm (it need not be purposeful movement). A questionnaire is initially sent to whoever inquires about qualifying for the program. Once this questionnaire is returned, a therapist contacts the individual or family in order to advise them on how to proceed.
Children and Adults who have moderate to severe contractures in the joints of their involved arm may not qualify for the program.
Children and Adults with severe cognitive impairments may not qualify for the program.
Even if past tradition rehabilitation methods have provided only minimal improvement, children and adults can still reap considerable benefits from this program. The human brain is changeable (plastic) until the day you die. It is a matter of knowing how to activate change and build confidence effectively.
Children with a diagnosis of any of the following and who experience impaired function in one of their arms may qualify for the program:
- Cerebral Palsy
- Traumatic Brain Injury
- Brachial Plexus Injury
- Childhood stroke
- Any other neurological impairment that affects the use of one arm or hand
Adults with a diagnosis of any of the following and who experience impaired function in one of their arms may qualify for the program:
- Stroke (one+ year post stroke is optimal)
- Traumatic Brain Injury
- Hydrocephalus with one arm paralysis involvement
- Multiple Sclerosis
- Any other neurological impairment that impacts the ability to use one arm