But the U-M program, started in 1999, is not as lengthy or as intense, and is covered by most insurance as part of rehabilitation. It's aimed at those who had their strokes more than six months before. All CIT, McDowell explains, is based on recent scientific findings that challenge conventional thought about how the brain and body's network of muscle-controlling nerves respond to damage caused when a stroke interrupts blood flow to parts of the brain. So, when somebody had a stroke that affected the left side of the brain and caused the right arm and leg to become weak, the focus for rehabilitation was to support the right arm so the patient wouldn't get pain syndromes or experience a dropping of the shoulder. Then, we would teach the left hand to take over functions, even for people who are right-handed.
Some patients compare it to an oven mitt or a boxing glove.
Patients wear the constraint for two weeks, for 23 hours a day, and keep a log of what they are able to do with their weak limb. They also participate in six group sessions with other patients who are also undergoing CIT, doing practical things like playing cards and making cookies. Patient Robert Callsen, for example, is recovering well from a 1999 stroke because of CIT and other therapies. Now, I've come this far that I've been able to open the hand and do different things with it. I'm able to drive and get around, and this program has enabled me to use my left hand more than ever.