[New developments in stroke rehabilitation based on behavioral and neuroscientific principles: constraint-induced...

Recent discoveries about the central nervous system's response to injury and how patients reacquire behavioral capabilities by training have yielded promising new therapies for neurorehabilitation. This family of interventions is termed constraint-induced (CI) therapy and is essentially behavioral in nature. Constraining movement of the arm which is less affected by the stroke and training (by shaping) the more affected arm for many hours a day for two consecutive weeks proved effective in the treatment of hemiplegia in many studies. Successful applications other than for stroke have been for traumatic brain injury, cerebral palsy, spinal cord injury, fractured hip, and focal hand dystonia. Extending the principles to other consequences of stroke such as aphasia is examined. Constraint-induced therapy is shown to produce large changes in the organization and function of the brain,which emphasizes the significance of cortical reorganization and learning for neurorehabilitation.