• Rinske Nijland, Erwin van Wegen, Hanneke van der Krogt, Chantal Bakker, Floor Buma, Asbjørn Klomp, Joost van Kordelaar, Gert Kwakkel, and EXPLICIT-stroke consortium.
• Department of Rehabilitation Medicine, Research Institute MOVE, VU University Medical Centre, Amsterdam, The Netherlands.
• Physiother Res Int. 2013 Mar 1;18(1):1-15.

AbstractConstraint-induced movement therapy (CIMT) is a commonly used rehabilitation intervention to improve upper limb function after stroke. CIMT was originally developed for patients with a chronic upper limb paresis. Although there are indications that exercise interventions should start as early as possible after stroke, only a few randomized controlled trials have been published on either CIMT or modified forms of CIMT (mCIMT) during the acute phase after stroke. The implementation of (m)CIMT in published studies is very heterogeneous in terms of content, timing and intensity of therapy. Moreover, mCIMT studies often fail to provide a detailed description of the protocol applied. The purpose of the present paper is therefore to describe the essential elements of the mCIMT protocol as developed for the EXplaining PLastICITy after stroke (EXPLICIT-stroke) study. The EXPLICIT-stroke mCIMT protocol emphasizes restoring body functions, while preventing the development of compensatory movement strategies. More specifically, the intervention aims to improve active wrist -and finger extension, which is assumed to be a key factor for upper limb function. The intervention starts within 2 weeks after stroke onset. The protocol retains two of the three key elements of the original CIMT protocol, that is, repetitive training and the constraining element. Repetitive task training is applied for 1 hour per working day, and the patients wear a mitt for at least 3 hours per day for three consecutive weeks.Copyright © 2012 John Wiley & Sons, Ltd.

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