The Neuroplasticity-Based Faculty Practice offers intensive therapy programs that have been shown to produce beneficial neuroplastic brain change.

The therapy programs to offered in this clinic will include Constraint-Induced Movement Therapy (CI Therapy). Future programs may include LSVT-BIG for individuals with Parkinson’s Disease, SENSe training for retraining sensation following stroke who experience sensory loss or changes, and other treatments that focus on beneficial brain change.

Constraint-Induced Movement Therapy (CI Therapy or CIMT) is a behavioral,neurorehabilitation program developed by Edward Taub, Ph.D. and his colleagues in the CI Therapy Research Group at UAB. Although CIMT consists of a family of therapies, they share the same concepts used in teaching the brain to “rewire” itself. Dr. Taub’s research has proven that individuals who qualify for each program can learn how to improve the motor ability of the more-affected extremity through behavioral and physical interventions to promote use of the more-affected extremity.

Yes, the same CI Therapy protocols that were developed over the years in the CI Therapy Research Laboratory and Taub Therapy Clinic are now offered in the Neuroplasticity Rehabilitation Program.

Potential candidates include adolescents and adults who have neurological illness or injury resulting from stroke, acquired brain injury/traumatic brain injury (TBI), multiple sclerosis (MS), and other conditions. CI Therapy is offered at least 6 months after your injury; however, interested patients may contact us to start the process of evaluation at 3 months after injury.

Since 1987, Dr. Taub’s CI Therapy Research Group has worked with a large volume of participants with mild to severe impairment of the more-affected upper extremity. While many people are treated somewhere between 6 months to 2 years of the time of stroke or neurological event, our patients have participated in CI Therapy more than 10 to 20 years out an as far out as 50 years post-stroke with good results. In the CI Therapy Research Group and in the former Taub Therapy Clinic, we have found that treatment is not dependent on getting the therapy quickly after stroke. Rather it is more important to be medically stable and ready to participate fully in the intensive treatment program. Individual improvement in clinical practice follows closely with what was found in CI Therapy research as long as the patient is medically stable and adheres closely with the treatment program.

Common neurological impairments treated in the Upper Extremity CI Therapy program include: weakness of the more-affected arm and hand; decreased use of more-affected arm and hand in the everyday life situation; decreased coordination and fine motor skills; difficulty performing daily selfcare tasks such as dressing, grooming, and eating to name a few; difficulty performing instrumental activities of daily living like using a computer keyboard or mouse, preparing meals, or performing other tasks that are important to the individual.

To apply, you need to complete a four-step process that will determine if our CI Therapy programs are a good match for you.

Step 1: You Complete Our Form

Complete our Patient Information Form by clicking here to download and print, and then sending via standard mail or dedicated fax.

Submit by mail to this address:
Neuroplasticity Rehabilitation Program
Attn: Mary Bowman, OTR/L
UAB School of Health Professions
SHPB 360Z 1720 2nd Ave South
Birmingham, AL 35294-1212

Submit by fax to: 205-996-0069.

Step 2: We Review Your Form

Once we receive your Patient Information Form, one of our therapists that specializes in CI Therapy will review it. We will communicate the therapist's findings to you. If appropriate, one of our therapists will set up a CI Therapy video screening call.

Step 3: Screening by Video Call

We will complete a 30-minute video call with you to carry out a screening. Based on the results of the CI Therapy video screening call, we will contact you to notify you of the findings of the screening process.

IF YES: If you appear to meet the screening criteria, we will schedule you for an in-person CI Therapy Assessment and possible treatment in our therapy program.

IF NO: If it is determined that you do not yet meet the criteria, a therapist from the clinic will contact you to discuss why you did not meet the criteria. If desired, you and the therapist may set a date in the future to reconnect to see if your movement has improved enough to re-screen you for possible treatment.

Step 4: In-Person Therapy Assessment

The final step to determine if you are good candidate for CI Therapy is an in-person Therapy Assessment. During this assessment, a therapist will evaluate many aspects of participation criteria, including active movement of your more-affected arm and hand. If it appears that you meet the criteria for participation and are medically stable, then we will proceed into treatment. If you do not meet the criteria, we will communicate with you about the issue and suggest options for you to consider that may help resolve the issue prior to a possible future reassessment.

Our clinic therapists will review your Patient Information Form and, if appropriate, set up a video screening call with you. If, after reviewing your information, it appears that you may meet the movement criteria, then we will notify you and proceed to scheduling. If it is determined that you do not meet the criteria for one of our treatment programs, we will inform you of this decision and provide suggestions for future consideration.

We make every attempt to thoroughly screen individuals for assessment and treatment before patients and families travel to Birmingham. However, we cannot completely confirm that you will meet all qualifications for treatment until you have completed the in-person Therapy Assessment with one of our therapists in our clinical space.

If you have a medical condition that does not appear stable, then your doctor will need to address this condition prior to treatment in our program. Some conditions may make it unsafe for you to participate in our programs at any time.

This treatment program is a fee-for-service program. We have intentionally worked to keep the cost for treatment of our therapy program as low as possible.

• $200 for a CI Therapy Assessment.
• $100 for materials and equipment to support your treatment needs.

The fees for each program depend on the program that you need based on the severity of your arm and hand impairment.

• $4,850: Two-Week Arm and Hand CI Therapy Program:
1. One-on-one treatment with a therapist who specializes in CI Therapy for 3.5 hours a day for 5 days per week (for those with minimal to moderate impairments as defined in our CI Therapy Program).
• $7,125: Three-Week Arm and Hand CI Therapy Program:
1. One-on-one treatment with a therapist who specializes in CI Therapy for 3.5 hours per day for 5 days per week (for those with moderate to severe impairments as defined in CI Therapy).

The CI Therapy clinic operates on a fee-for-service basis. You will need to provide payment in full on your first day of treatment. Acceptable payment methods include credit card, cash, money order, or cashier’s check.

Individuals are responsible for all travel, lodging, and food expenses during their stay in Birmingham. We will provide a list of area hotels and lodging options that have been recommended to us by former patients. We will also provide information on local agencies and organizations that offer reduced-cost housing for individuals while they receive treatment at UAB.

Treatment is most often provided 3.5 hours a day on 5 consecutive weekdays for 2 to 3 weeks. Although CI Therapy is an intensive program, we will create an individual program for you to give you the most improvement possible while allowing for appropriate rest breaks. Your treatment will follow the UAB CI Therapy Research methods closely.

Each day, after you complete treatment in the clinic, your therapist will ask you to complete home practice activities in the evenings and on weekends. Completing these assignments is a crucial step in producing successful treatment outcomes.

After completing your CIMT treatment program, your therapist will give you an individualized program to follow upon your return home after treatment. Your therapist will also ask you to complete four self-assessments that will help you and the clinic in track your progress once you have returned home.

Upper Extremity CI Therapy Programs

Your therapist will determine the length of treatment most appropriate for you based on how much arm and hand function you have. The screening and assessment process helps us determine if you need the 2-week or 3-week program.

No, it is not possible to complete treatment for both your more-affected arm and more-affected leg at the same. We have tried to treat patients with both programs at the same time but have found that this prevents patients from gaining the full amount of improvement possible in both their arm and leg.

We provide treatment for only one limb or function at a time. Patients must continue to work on the use of that function for 3 months before we treat another limb or function.

Most individuals have found that CI Therapy is challenging but satisfying. The treatment may feel challenging mostly because of the intensity, frequency, and length of the program.

At first, some of our patients may feel frustrated and tired. Your therapists will work with you to give you rest breaks as needed. It is important that you and your family discuss your goals for treatment and the reason that you are coming for treatment.

It is very important that you:

• Make the decision to apply and participate in treatment for yourself.
• Want to improve your functional ability.
• Set realistic, specific goals for yourself to improve your functional ability in your daily life that can be measured and are meaningful to you.
• Are motivated to work hard and achieve your goals.
• Enter the program willing to focus on your treatment and follow instructions.
• Are determined and committed to participating in this program.

The treatment provided in the Neuroplasticity Rehabilitation Program is based on evidence gained from extensive clinical research in CI Therapy. This research has shown that CI Therapy is effective for the recovery of function after stroke and traumatic brain injury regardless of time since injury. The treatment provided is based on the findings of multiple randomized controlled trials in the CI Therapy Research Group and in studies that have reproduced this method around the world. CI Therapy provided in the Neuroplasticity Rehabilitation Program is provided by therapists who have specialized in this treatment approach and instruct other practitioners in the UAB Training for CI Therapy Course.

We strongly recommend that you have someone come with you when you come to UAB to participate in CI Therapy. When patients come alone, we find that they are not able to do the home tasks and wear the mitt because they must remove the mitt to get meals and drive themselves. We encourage everyone coming to UAB for treatment to have someone travel with them to help them set up a daily routine while the patient participates in treatment.

No, we do not typically work with individuals younger than 14 years in the Neuroplasticity Rehabilitation Program. Instead, we recommend that parents contact the Pediatric Constraint-Induced Therapy Clinic at Children’s of Alabama at 205-638-6293 or by clicking here to visit their website.

Yes, at UAB we offer both online and in-person versions of the training for CI Therapy. Please see these websites for more information.

Online

For more information on the Online UAB Training for CI Therapy that offers didactic lectures on the theoretical background, foundational studies, outcome testing, and therapy procedures for the adult upper extremity version of CI Therapy, please click here to visit the website.

In-Person

For more information on the in-person version, a biannual 5-day continuing education course providing UAB Training for CI Therapy on the UAB campus, please click here to visit the website.

The in-person training course offers 2 days of didactic lectures followed by lab practical experiences with participants with stroke to put the procedures into practice. The training for the adult upper extremity and lower extremity CI Therapy protocols is offered twice a year (spring and fall) and the training for the pediatric upper extremity CI Therapy protocols is offered in the fall only.