Constraint Induced Movement Therapy (CIMT) plus Bimanual Training (BIT) is a therapeutic approach for patients who have difficulty using one arm or hand due to neuromuscular impairment such as hemiplegia, hemiparesis, or brachial plexus injury.  Decreased range of motion, strength, coordination or sensation in the affected upper extremity often impacts an individual’s ability to complete activities that require the use of two hands.  An Intensive CIMT and BIT program may be of most benefit to individuals with ability to initiate some controlled movement of the more affected upper extremity, ability to actively participate in an intensive therapy program and have caregiver support to implement a home program through the course of the CIMT program.

Participants in an Intensive CIMT and BIT program are evaluated and treated in a one-on-one setting by an Occupational Therapist (OT).  Use of the better arm is limited through wear of a constraint and the OT facilitates use of the more affected upper extremity through engagement in functional activities.  Goals of treatment include improving frequency of spontaneous use, quality of movement and overall function of the affected upper extremity.  BIT is completed following an episode of CIMT and consists of repeated practice of two-handed, or bimanual, activities to improve an individual’s ability to better use their more affected upper extremity in functional daily activities.

Patients and caregivers are provided with support and strategies to implement a home program for the duration of the program and to establish a home program for maintaining gains following completion of the program.