Constraint Induced Movement Therapy (CIMT)

Constraint Induced Movement Therapy (CIMT) is a therapy technique to treat children who have neuromotor conditions that affect one side of their body. Sometimes CIMT is referred to as “movement therapy” or “constraint therapy.”

Some children who have neuromotor conditions avoid using two hands during play and other daily activities. Often, they use their stronger hand but neglect to use their weaker hand. This is called developmental—or learned—nonuse.

CIMT uses a cast to limit the use of the stronger hand for four weeks. This encourages children to use their weaker, affected hand, which helps them strengthen it and learn to use it more skillfully. During CIMT, children build new skills for play, and they practice everyday tasks such as getting dressed, combing their hair and feeding themselves.

Kids who have difficulty using one arm or hand might benefit from CIMT, which can be used to treat conditions such as:

• Hemiplegic cerebral palsy.

• Acquired brain injury.

• Birth brachial plexus injury.

If your child has one of these conditions, CIMT might be part of their treatment plan.

During an evaluation

Before participating in CIMT at Gillette Children’s, your child is evaluated by a pediatric occupational therapist. The evaluation assesses your child’s awareness of the affected hand. We also evaluate ability to move and feel the weaker hand and to use it during self-care and play.

As part of the evaluation, Gillette therapists:

• Provide an overview of occupational therapy services available to your family.
• Assess your child’s social skills, emotional competence, reasoning and awareness.
• Consider your child’s abilities before deciding if CIMT is right for your child.

During Therapy

If an evaluation determines that your child can benefit from CIMT, here’s what you can expect from therapy:

• We work with you to set goals for your child and help prepare your family for the CIMT process.
• Your child wears a cast on their stronger arm and hand for four weeks.
• A pediatric occupational therapist works closely with your family to develop a program of activities and exercises that your child can do at home while wearing the cast.
• Through activities and exercises, your child trains the muscles in their more affected hand or arm (the one without the cast).
• Your child returns to Gillette for clinic appointments while wearing the cast. The frequency of appointments is determined in the evaluation. During appointments, home activities might be modified so that the therapy continues to challenge your child.
• After the cast is removed, your child might need more therapy to learn how to use newly developed skills during two-handed activities.

When your family comes to Gillette for your child’s CIMT, they benefit from the latest occupational therapy techniques and research, such as a collaborative study with the University of Minnesota involving CIMT.

It’s our job to coordinate your child’s medical and rehabilitative care, which can include CIMT, occupational therapy and other services to care for your child’s overall well-being. As part of a comprehensive treatment plan, your family might work with many specialties and services, including:

• Music therapy.
• Neurology.
• Orthopedics.
• Physical therapy.
• Rehabilitation medicine.
• School services.
• Speech/Language therapy.