Constraint-Induced Movement Therapy for Stroke Recovery
Constraint-induced movement therapy (CIMT) is one of the most well-researched and effective treatments for upper limb recovery after stroke. It is based on a simple but powerful principle: by restricting the unaffected arm, the patient is forced to use the affected arm, driving neuroplastic changes in the brain and overcoming learned non-use.
Learned non-use is a key barrier to arm recovery after stroke. When the affected arm is weak or uncoordinated, the patient naturally uses the unaffected arm for tasks. Over time, the brain reduces its investment in the affected arm, and the pathways that could support recovery weaken further. This creates a self-reinforcing cycle of decline.
CIMT breaks this cycle. The unaffected arm is restrained with a mitt or sling for several hours a day — typically six hours over a two-week intensive programme. During this time, the patient performs intensive, repetitive task practice with the affected arm, guided by a physiotherapist. Tasks are progressively challenging, tailored to the patient's abilities and functional goals.
Research shows CIMT produces significant improvements in arm function, even in patients who are months or years post-stroke. The intensity of practice drives neuroplastic change, while the restraint overcomes the habit of relying on the unaffected arm.
CIMT is not suitable for all stroke survivors. It requires some active movement in the affected arm (typically the ability to extend the wrist and fingers) and sufficient cognitive function and motivation to participate in intensive practice. For patients who do not meet these criteria, modified CIMT or other upper limb rehabilitation approaches may be more appropriate.
Our stroke rehabilitation service incorporates CIMT and other evidence-based upper limb therapies. Delivered at home, treatment uses real objects and tasks in the patient's own environment. Our neurological physiotherapy service provides specialist expertise for complex upper limb recovery, ensuring each patient receives the most appropriate and effective treatment.