Shaping Exploration: How Does the Constraint-Induced Movement Therapy Helps Patients Finding a New Movement Solution

Despite the relative success of constraint-induced movement therapy in the recovery of injury-/trauma-related populations, the mechanisms by which it promotes its results are still unknown. From a dynamical systems approach, we investigated whether the induced exploratory patterns within and between trials during an exercise in Shaping (the therapy's practice) could shed light on this process. We analyzed data from four chronic spinal-cord injury patients during a task of placing and removing their feet from a step. We assessed the within and between trial dynamics through recurrent quantification analyses and task-space analyses, respectively. From our results, individuals found movement patterns directed to modulate foot height (to accomplish the task). Additionally, when the task was manipulated (increasing step height), individuals increased coupling and coupling variability in the ankle, hip, and knee over trials. This pattern of findings is in consonance with the idea of Shaping inducing exploration of different movements. Such exploration might be an important factor affording the positive changes observed in the literature.