What are the "ingredients" of modified constraint-induced therapy? An evidence-based review, recipe, and recommendations.

Modified constraint induced movement therapy (mCIT) increases paretic upper extremity use and movement in all phases of stroke. Although fundamental to its appropriate implementation, specific details on day to day implementation on this promising family of therapies have not heretofore been published. Consequently, some integral behavioral facets of mCIT may be overlooked, while other approaches may be easily mistaken to constitute mCIT, during attempts to implement the therapy. The purpose of this paper is to review mCIT, and to provide the clinician-reader with a detailed description of the "ingredients" of mCIT and their rationale, including clinical examples of these components. It is expected that a more complete understanding of the components comprising this promising approach will overcome knowledge barriers associated with its appropriate use, and encourage better patient management in clinical practice.