CI Therapy - The Process
CI therapy for the arm mainly involves intensively training the weaker arm while at the same time preventing use of the stronger arm after a stroke, multiple sclerosis (MS) or traumatic brain injury (TBI) by placing it in a mitt for 90% of waking hours over two or three weeks (depending on the severity of the impairment in movement).
CI therapy techniques have been extended to treat:
- The leg in individuals with stroke, spinal cord injury, or fractured hip
- The arm in young children with cerebral palsy
- The arm or leg after traumatic brain injury
- Incoordination of the fingers in musicians with focal hand dystonia
- Language in patients with aphasia after stroke
Why CI Therapy Works
The treatment is thought to work because it overcomes a strong tendency not to use the weaker arm (“learned nonuse”) that develops early after stroke, MS or TBI. In addition, CI therapy produces a large "rewiring" of the brain; that is, after treatment, more of the brain works to move the weaker arm than before therapy.
Thousands of patients with stroke and TBI have been treated by several laboratories in many different countries that are associated with this laboratory. Over 300 patients have been treated at this institution. They have had mild to moderately severe stroke, MS or TBI. Most of these patients have improved substantially in their ability to use their weaker arm or leg in the activities of daily living at home.
Staying with the Program
Participation in the project requires a good deal of self-discipline. A practice program to be carried out at home is provided for each participant to complete while they are enrolled in treatment in addition to their work in the laboratory. Participants must be willing to work diligently during the daily therapy sessions in the laboratory as well as away from the laboratory.
Failure to comply with project guidelines will reduce the effectiveness of the therapy. Those who have improved the most worked with the program daily and followed all project instructions.
Has CI therapy been successful for others?
Our institution has treated over 300 patients who had their strokes more than one year before the beginning of treatment, with many patients having their stroke more than 20 years earlier. While the amount of individual improvement has varied, most of patients have shown a marked increase in the functional ability of the affected arm or leg.
Who is responsible for this laboratory?
CI therapy was developed by Edward Taub, Ph.D. and co-workers. It is currently administered by the University of Alabama at Birmingham. It is funded by the National Institutes of Health and the MS Society.
How does the evaluation and selection process work?
Potential research patients are evaluated by our physicians and physical or occupational therapists to ensure that they will have a good chance of benefiting from our program. The evaluation involves determining a patient's health status, movement ability, balance, cognitive ability, and functional ability.
Who will be treating me?
The therapy is conducted by trained staff who are in close contact with Dr. Taub and other project members, including physicians, physical or occupational therapists, and administrators.
Where is the therapy carried out?
Therapy is conducted at the University of Alabama at Birmingham in Alabama.
Where will I stay while receiving therapy if I am coming from outside the Birmingham area?
Accommodations are not provided by the project, but a listing of local hotels can be obtained from the project staff. You may choose the location that best suits your needs. Also, you are free to make any other arrangements you would like for the treatment period. Transportation from the hotel to the treatment center may be provided by the hotel's van service, when it is needed.
How much will the treatment cost?
If you qualify for a research project, the treatment you receive will be at no cost. However, you will be responsible for your meals, lodging, and transportation (please see above).
How can I sponsor a person?
In the event that you or someone you know would be interested in providing a partial or full scholarship for a person who cannot afford airfare and food and lodging costs when away from home, please let us know. All contributions to the laboratory are fully tax-deductible.
How long does the therapy last?
Depending on which type of treatment you receive, therapy will usually last 2-1/2 or 3-1/2 weeks. The amount of treatment given each day will vary depending on the specific study you are in. Rest periods are given at frequent intervals and vary with each participant's need.
Can someone accompany patients to the therapy session?
Guests may come with the patient to the facility, but are discouraged from remaining during therapy. However, family members are occasionally asked to come into the laboratory to answer some questions and to obtain instructions on how to help the patient continue improving in amount of use of the weaker arm when at home.
Would you like to know more?
If you would like to know more, please contact Staci McKay at:
CI Therapy Research Group
University of Alabama at Birmingham
1720 2nd Avenue South,
Birmingham, AL 35294-0018
Phone: (205) 934-9768