Constraint-induced movement therapy: from history to plasticity

Constraint-induced movement therapy (CIMT) is a rehabilitative strategy applied primarily to the post-stroke population to increase the functional use of the neurologically weaker upper extremity through massed practice, while restraining the lesser involved upper extremity. Although recent Cochrane reviews have reported success with CIMT, this therapeutic technique is difficult to deliver because it requires proper allocation of resources by both clinicians and patients. Therefore, identifying those individuals who benefit most from the intervention is essential. Since most studies include heterogeneous populations, the effect of the intervention for certain subgroups could be masked. Therefore, understanding the possible neuropredictors of recovery can help target the appropriate populations. This special report briefly presents the history of CIMT and its underpinnings in the psychology literature; however, 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.