Constraint therapy involves 1 or more hours of therapy per week that focuses exclusively on the hemiplegic hand. Clients also have to wear 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 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 straighten their fingers 10 degrees and their wrist 20 degrees. 2) It can be a problem for women who's husbands are not willing to do chores at home while wives constrain their sound hand all day.
Current research offers an alternative. Clients can use their sound hand to guide the affected hand while making lunch, eating, and cleaning up (1). Stroke survivors who were helped to use their hemiplegic hand during for 90 or 180 minutes improved as much as subjects who received constraint therapy for the same amount of time (2). homeafterstroke.blogspot.com
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:
My experience was that forced use required me to recover. I had to take care of my son. I needed two hands to do what I needed to do. My hand/arm is not perfectly functioning but it is functional enough to do what I need to do most of the time. Luck? Maybe. Forced use? Yes!
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