The functional significance of cortical reorganization and the parallel development of CI therapy

For many years, the prevailing view was that the adult brain was hardwired and unable to change after injury. However, research has shown that the brain is capable of reorganization and recovery of function, even in the chronic phase after CNS injury. Constraint-Induced Movement therapy (CI therapy) is a rehabilitation treatment that has been developed to improve motor deficits in humans after stroke and other types of CNS damage. CI therapy works by encouraging the use of the affected limb and discouraging the use of the unaffected limb. Studies have shown that CI therapy is accompanied by changes in the function and structure of the brain, and that these changes are correlated with the improvement in motor function that the treatment produces. This suggests that cortical reorganization plays a role in the recovery of function after CNS injury.

• 1
  Increased use of a limb, facilitated by CI therapy, leads to an expansion of the cortical representation zone of that body part.
• 2
  Gray matter increases in sensorimotor cortices and hippocampi are observed in stroke patients receiving CI therapy, and these changes are correlated with increased use of the more-affected arm in daily life.
• 3
  CI therapy has been successfully applied to improve motor deficits resulting from various types of CNS damage, including traumatic brain injury, multiple sclerosis, cerebral palsy, and aphasia after stroke.