Lippincott Williams and Wilkins
Place of Publication
School of Nursing and Midwifery
Stroke is one of the main causes of disability worldwide, commonly affecting balance, speech, and coordination. Most stroke survivors need long-term support with activities of daily living (ADLs), especially in cases of hemiparesis. Among the management approaches to improve function of the upper extremities in hemiparesis is CIMT, which is based on two principles: the forced use of the affected arm by restraining the unaffected arm (with a sling or hand splint) during exercise or while performing ADLs for 90% of the patient's waking hours; and exercise of the affected arm such that movement is accomplished in small steps of progressively increasing difficulty. Modified forms of CIMT exist, with reduced exercise time or no exercise during the period of restraint. The rationale for CIMT is based on the theory of "learned non-use," which predicts that following stroke people have greater movement ability than they realize.