Constraint-Induced Movement Therapy (Taub's Training) for Stroke Patients with Pareses of Different Severity Levels

The „Constraint-Induced Movement Therapy“ is a therapy to treat motoric disorders caused by stroke or other brain damages. It is a behaviorally oriented program, which is based on the principles of learning psychology. The theoretical background of the therapy is described in a theory called „Learned Nonuse“. It assumes, that a part of the motoric disablement of stroke patients is not caused by the neurological damage but can be ascribed to a conditioned suppression of behavior. The aim of the therapy is therefore to overcome the „Learned Nonuse“ and to transfer the motoric skills, which have been reacquired through the training, in everyday life. In total, 64 patients who suffered from motoric impairment of the upper extremity after stroke have been examined. Depending on the degree of the motoric impairment, patients were divided into a group called „less strongly affected“ and a group called „strongly affected“. The assignment to the two groups took place after self-defined criteria. The training took place over a period of 10 („less strongly affected“) up to 12 („strongly affected“) training sessions with a daily training time of about 5 hours. During this time, patients had to accomplish various exercises, which had to be conducted solely by the affected extremity. At the same time, movements of the unaffected upper extremity were impeded through the wearing of a splint combined with a loop. This device ensured that the patients also had to use the paralyzed extremity in everyday life in order to conduct motoric actions. Before and after the training intense neuropsychological and motoric diagnostics took place, which were specifically adjusted to the two groups of patients. Results of this diagnostic examination show that the therapy brought about (not only during the training situation itself but also during the accomplishment of everyday tasks) an enhancement of movement quality as well as a heightened use of the paralyzed extremity.