Constraint-induced movement therapy (CIMT), a rehabilitation technique originally developed for stroke patients, may also be effective in improving limb use in the daily activities of multiple sclerosis (MS) patients, results from a Phase 2 trial show.
Findings were reported in the study, “Phase II Randomized Controlled Trial of Constraint-Induced Movement Therapy in Multiple Sclerosis. Part 1: Effects on Real-World Function,” published in the journal Neurorehabilitation and Neural Repair.
In a second study, “Phase II Randomized Controlled Trial of Constraint-Induced Movement Therapy in Multiple Sclerosis. Part 2: Effect on White Matter Integrity,” published in the same journal, researchers found that CIMT results in changes in the white matter structure in the brains of MS patients, indicating that the improved capacity is the result of measurable changes in the brain at the end of the treatment.
“These are momentous findings, which could be game-changing for patients with MS,” Victor Mark, MD, primary investigator of both studies and an associate professor in the department of physical medicine and rehabilitation at the University of Alabama School of Medicine in Birmingham, said in a press release.
The therapy was developed based on the theory of “learned non-use,” in which, after a stroke or other condition causing limb impairment, patients learn to not use that limb for daily activities, relying instead on the better limb.
CIMT focuses on restraining the better limb to more intensively train the more affected limb on movements and activities related to daily living. Behavioral techniques are also included in CIMT, such as behavioral shaping, which involves achieving motor goals in small increments along with positive feedback and encouragement, and methods used to assist patients in transferring the training benefits of the therapy from the clinical setting to the real world, called the transfer package.
This randomized Phase 2 trial (NCT01081275) compared the use of CIMT with a therapy called complementary and alternative medicine (CAM) in improving the upper limb function of 20 MS patients.
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