Modified constraint-induced therapy: a promising restorative outpatient therapy

Stroke is the leading cause of disability in the United States, and upper limb hemiparesis is a primary impairment resulting in this disability. However, there remains a paucity of scientifically validated treatment regimens for hemiparesis. Data from randomized controlled studies suggest the effectiveness and efficacy of modified constraint-induced therapy (mCIT), a reimbursable, outpatient, upper limb training regimen. The purpose of this article is to review evidence and discuss the theoretical bases of mCIT for stroke-induced hemiparesis. The objective is to make stroke practitioners aware of the mCIT theoretical bases and of this clinically practical, efficacious protocol.

mCIT is solidly grounded in motor learning principles, is practical and safe, and is both efficacious and effective. mCIT studies have shown efficacy using rigorous randomized controlled methods in both subacute and chronic stroke and have shown high effect sizes that have been independently confirmed. It thus seems reasonable to recommend mCIT for clinical application.