CI Therapy - The Process
In adults after stroke, multiple sclerosis (MS), or traumatic brain injury (TBI), CI therapy for the arm mainly involves intensively training the weaker arm over two to three weeks (depending on the severity of the impairment in movement) while at the same time preventing use of the stronger arm by placing it in a mitt for 90% of waking hours.
CI Therapy for cognitive impairment (CICT) involves intensively training speed of processing and performance in carrying out everyday tasks related to cognitive function.
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
- Problems with thinking in adults after COVID-19 or stroke.
Why CI Therapy Works?
The treatment for adults with persistent, impaired arm use after stroke, MS, or TBI is thought to work because it overcomes a strong tendency not to use the weaker arm (“learned nonuse”) that develops early after brain injury. 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.
Has CI Therapy been successful for others?
Thousands of adults with stroke and children with cerebral palsy with an impaired arm or leg across the world have received CI therapy. Our institution has treated over 300 adults with an arm or leg impairment 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. We have also treated over 700 children with impaired movement of their arms due to cerebral palsy or other neurological conditions.
CI Cognitive Therapy is a new extension of CI Therapy. This form of CI Therapy is designed to improve speed of information processing by the brain and performance of everyday tasks with important cognitive components. Preliminary and early findings suggest that patients respond in the same, markedly positive way that patients with motor and speech difficulties respond to CI Movement and Aphasia therapy.
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.
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. The research has been funded by the National Institutes of Health, Department of Veterans Affairs, Department of Defense, the MS Society, the Integrative Center for Aging Research at UAB and others.
How does the evaluation and selection process work?
Potential research patients are evaluated by our research team 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 or occupational therapists, and administrators.
Where is the therapy carried out?
The research studies are conducted at the University of Alabama at Birmingham in Alabama. Treatment on a clinical basis is conducted in a private practice setting, which you may contact at citherapyinfo@gmail.com.
Where will I stay while receiving therapy if I am coming from outside the Birminhagm 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 to 4 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?
We strongly encourage patients to attend every training session with a family member, friend, or caregiver who lives with the pateient or has a frequent and close contact with them. That person can play an important role in the therapy. He or she can help the patient to tell the therapist what is going on in their daily lives, learn how to skillfully support the pateint in accomplishing daily tasks, and, after the session is over, remind the patient to do the home practice tasks that are assigned.
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, STE CPM C110
Birmingham, AL 35294-0018
Phone: (205) 934-9768
Email: cilab@uab.edu