The Functional Recovery and the Associated Cortical Reorganization Following Constraint-Induced Movement Therapies (CIMTs) in Stroke

A. Ahmad
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Abstract

Constraint-Induced Movement Therapies (CIMTs) including the original Constraint- Induced Movement Therapy (CIMT) and the Modified Constraint-Induced Movement Therapy (mCIMT) gained considerable popularity as a treatment approach for upper extremity rehabilitation among patients with mild-to-moderate stroke. However, a major barrier in rehabilitation generally and in CIMTs specifically; is the limited objectivity of some commonly used outcome measures and lack sensitivity to define “True” recovery vs. compensation. Thereby, they may not sufficiently detect of long term consequences and the associated neurological recovery. An essential approach to overcome such barrier is to better understand functional motor recovery, associated neural changes and how they may relate to recovery of the pre-morbid movement pattern. Such Understanding for these relationships would add more in-depth insights on the functional relevance of plastic brain changes in stroke following CIMTs to optimize the field of neuro-rehabilitation. This review synthesizes findings from studies to on the use of the CIMTs including CIMT and mCIMT as efficient practice in the management of upper limb dysfunction following a stroke. The analysis will include (1) the functional recovery and (2) the cortical reorganization following the use of mCIMT and CIMT on patients in the chronic stage following stroke.
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脑卒中限制性运动治疗后的功能恢复及相关的皮质重组
约束诱导运动疗法(CIMT),包括最初的约束诱导运动治疗(CIMT)和改良的约束诱导移动治疗(mCIMT)作为轻度至中度中风患者上肢康复的治疗方法,受到了相当大的欢迎。然而,康复的一个主要障碍,特别是CIMT;是一些常用的结果测量的客观性有限,并且缺乏对“真实”恢复与补偿的定义的敏感性。因此,他们可能无法充分检测到长期后果和相关的神经系统恢复。克服这一障碍的一个重要方法是更好地了解功能性运动恢复、相关的神经变化以及它们与病前运动模式的恢复之间的关系。对这些关系的理解将为CIMT后中风中大脑可塑性变化的功能相关性提供更深入的见解,以优化神经康复领域。这篇综述综合了关于使用CIMT的研究结果,包括CIMT和mCIMT作为治疗中风后上肢功能障碍的有效实践。该分析将包括(1)功能恢复和(2)对中风后慢性期患者使用mCIMT和CIMT后的皮层重组。
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