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Constraint-induced movement therapy (CI, CIT, or CIMT) is a form of rehabilitation therapy that improves upper extremity function in stroke and other central nervous system damage patients by increasing the use of their affected upper limb. [1]
There are several non-pharmacological interventions which are recommended for prevention and treatment of post-stroke hemiplegic shoulder pain. These include proper positioning, range of motion exercises, motor retraining, and adjuvant therapies like neuromuscular electric stimulation (NMES) (e.g. functional electric stimulation (FES)). [27]
The Fugl Meyer Assessment of Physical Performance (FMA) is an example of one widely used scale. [4] The FMA consists of five sub-scales that relate to various aspects of a patient's upper and lower extremity, and the sub-scales are as follows: [4] Motor; Balance; Sensation; Joint Range of Motion; Pain
Open chain exercises are postulated to be advantageous in rehabilitation settings because they can be easily manipulated to selectively target specific muscles, or specific heads of certain muscles, more effectively than their closed chain counterparts, at different phases of contraction.
For example, the PT or OT may analyze the activity of cooking. They may find, for example, that repetitive lifting of heavy skillets is a contributing factor to the individual's CTS symptoms. They may also observe the environment in which the activity is being performed and identify risk factors and compensatory strategies.
Range of motion (ROM) is when a person has become injured in some way, most times the doctor's advice the patients to exercise and stretch the back muscles. For this purpose a form of exercises called range of motion exercises which are used to keep the muscles and joints in the patients back strong and flexible.
Active assisted range of motion (or AAROM) – Patient uses the muscles surrounding the joint to perform the exercise but requires some help from the therapist or equipment (such as a strap). Active range of motion (or AROM ) – Patient performs the exercise to move the joint without any assistance to the muscles surrounding the joint.
The patient watches their hand or arm movements (for example) and corrects them as needed. [4] Although the technique is simple, needs virtually no exercise equipment, and can be done on one's own, concentration and some degree of perseverance is required. Research has shown that 20,000 to 30,000 repetitions may be required to produce results.
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