Methods to improve constraint-induced movement therapy.

In global terms, cerebrovascular stroke is the leading cause of long-term disability. Despite improved acute phase management of stroke, the majority of survivors are disabled and many require effective rehabilitation. Constraint-induced movement therapy (CIMT) is one of the recently emerging therapies for subjects with stroke. The effects of two-week long CIMT on behavioural, neurophysiologic and neuroimaging measures in subjects with chronic stroke were studied. Furthermore, the effects of combined upper limb exercise and peripheral preprogrammed multichannel electrical stimulation, i.e. functional electrical therapy (FET), were evaluated. Behavioral gains were obtained in hand function and functional MRI activations, and, in addition, TMS responses appeared more laterally and/or bilaterally in the affected hemisphere in the subjects after CIMT. Neurophysiologic and functional imaging results were supportive evidence for the benefits of use-dependent plasticity in subjects with chronic stroke.