Constraint therapy involves 1 or more hours of therapy that focuses exclusively on the hemiplegic hand plus wearing a mitt on the sound hand for 3+ hours at home each day to force the hemiplegic hand to work. Constraint therapy is good because it challenged long held beliefs that clients cannot recover function for years after a stroke.
Constraint therapy is bad because it is appropriate for a limited pool of clients. 1) Stroke survivors must already be able to extend (straighten) their fingers 10 degrees and their wrist 20 degrees.
2) It is good for men who have women to take care of them. Husbands may not be willing to help with chores at home while wives constrain their sound hand all day.
Current research offers an alternative. Hayner found guiding both hands to work while making lunch, eating, and cleaning up helped stroke survivors improve as much as subjects whose hand was constrained during the same activity (1). Sterr also found that stroke survivors who were helped to use their hemiplegic hand for 90 or 180 minutes improved as much as subjects who received constraint therapy for the same amount of time (2). These and other studies have shown that any practice which is intense can produce recovery.
1. Hayner K, Gibson G, Giles G. Comparison of constraint-induced therapy and bilateral treatment
of equal intensity in people with chronic upper-extremity dysfunction after cardiovascular
accident. American Journal of Occupational Therapy. 2010;64(4):528-539.
2. Sterr A, Oneill D, Dean P, Herron K. CI therapy is beneficial to patients with chronic low-
functioning hemiparesis after stroke. Front. Neurol. 2014;5: