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CIMT – Principle — SCE Neurology MCQ

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ModerateNeurorehabilitationCIMT – PrincipleSCE Neurology

A 55-year-old man with MS has progressive walking difficulty. His physiotherapist uses constraint-induced movement therapy (CIMT) for his upper limb weakness. What is the principle of CIMT?

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Correct answer: D — Constraining the unaffected limb (e.g. with a mitt or sling) to force intensive use of the affected limb — promoting motor recovery through use-dependent neuroplasticity

CIMT involves restricting the unaffected limb for ~90% of waking hours for 2–3 weeks, combined with intensive structured practice (6+ hours/day) of the affected limb. The principle is use-dependent neuroplasticity — intensive use of the affected limb drives cortical reorganisation and functional recovery. It was originally developed for stroke rehabilitation but is used in MS. Requirements: the patient must have ≥20° of active wrist extension and 10° of finger extension (to have enough function to use). A: The UNAFFECTED limb is constrained. C: Only the unaffected limb. D: Intensive active use is the mechanism. E: Movement practice, not passive therapy.

Reference: RCP Stroke Guidelines; EXCITE Trial