UAB Medicine

Taub Therapy - FAQ

What is CI Therapy?
A stroke and brain injury rehabilitation program developed by Edward Taub, Ph.D., CI therapy as provided by the Taub Therapy Clinic, is the most effective form of constraint-induced movement therapy (CI therapy). Although CI therapy consists of a family of therapies, they share the concept of teaching the brain to “rewire” itself. Dr. Taub’s research has proven that patients can learn how to improve the motor ability of their affected limb by ceasing to rely primarily on the unaffected limb, no matter how long ago the injury occurred.

Who is a candidate for CI Therapy?
Most candidates for CI therapy suffer from the chronic effects of a stroke and have already completed traditional post-stroke rehabilitation. However, Taub Therapy has also been proven to benefit those who have lost limb function due to traumatic brain injuries or brain damage from surgery or radiation therapy. CI therapy is effective no matter how long ago the stroke or injury occurred. CI therapy is designed to help people who can make at least some limited movement with the affected arm and hand. Patients applying for therapy for the affected leg must be able to walk about 25 feet, at least five times a day, with or without physical assistance.  The Taub Therapy Clinic does not currently treat patients with receptive aphasia, which is a language disorder caused by damage in a specific area of the brain that controls language expression and comprehension, and can leave a person unable to communicate effectively with others. Please contact a clinic therapist at 866-554-TAUB if you have aphasia-related questions.

How do I know if I do not meet the necessary qualifications for CI Therapy?
Based on the information you submit to the Taub Therapy Clinic, a determination will be made that your current level of function did not meet the required criteria for participating in the program and you will be notified.

How long should it be since my stroke occurred?
At least three months must have elapsed following stroke or other neurological injury, before a person is eligible for CI therapy.  However, CI therapy may be effective no matter how long ago the stroke occurred.

What is the treatment cost for CI Therapy?
The Taub Therapy Clinic operates on a fee-for-service basis. Medicare and other insurance plans do not currently pay for the treatment; however some patients have been reimbursed by their insurance companies post-therapy. You will be responsible for paying the clinic. Patients who receive treatment at the clinic will incur the following costs:
1) $450 for the medical evaluation and the therapy evaluations
2) $6,000 for the two-week upper extremity treatment program or $9,000 for the three-week, upper extremity treatment program, or $9,600 for the three-week, lower extremity program
3) Travel costs and lodging for the duration of your stay in Birmingham
Payment for the evaluations and for the treatment may be made using a credit card, money order or cashier’s check.

What kind of time commitment is involved for CI Therapy?
CI therapy is more effective than other therapy programs because of its intensity and its behavioral component.   Depending upon each patient’s condition, CI therapy may last two to three weeks for three and a half to four hours each day. Patients must also complete exercises independently in the evenings and on weekends. After completing CI therapy at the Taub Therapy Clinic, patients are given an individualized program to follow at home. The patient is also asked to complete four self-evaluations to help the clinic track progress and make recommendations for improving the home program.

Is CI Therapy right for me?
CI therapy is designed to be challenging. Patients often experience feelings of frustration and fatigue in the beginning before seeing improvement. That’s why it’s important for you to possess:
• passion for and commitment to the program
• unwavering determination to succeed
• willingness to focus and follow instructions
• motivation to work hard to achieve your goals
willingness to continue exercising after returning home

What sets
CI Therapy at the Taub Therapy apart from other CI therapy programs?
The first of its kind, the Taub Therapy Clinic has done more extensive clinical research on CI therapy than any other clinic in the world.  For those who meet the admission movement criteria, Dr. Taub’s methods have been proven to work no matter how long ago the stroke or brain injury occurred. No other program provides the intensive, therapist-guided practice of movement that is essential to CI therapy. Dr. Taub personally oversees treatment programs to ensure that each patient receives the best outcome possible.

Is the patient responsible for the expense of traveling and room and board?
Taub Therapy Clinic patients are responsible for all travel and room and board expenses. We will provide a list of area hotels that offer a discounted rate. We also provide information about our local state park for those patients who travel in RVs.

Why is a physical evaluation in Birmingham necessary?
After your application has been approved, you must undergo a physical evaluation by Victor Mark, M.D., Medical Director of the Taub Therapy Clinic, and a therapist from the clinic. This standard examination enables clinic staff to gauge your strength, flexibility, and functional ability.  It is also used to determine if there are any chronic conditions or other problems that could be aggravated during therapy. The total evaluation cost is $450.

How long does the evaluation last?
The evaluation takes approximately two hours.

What happens during therapy sessions?
A physical or occupational therapist works exclusively with each patient to practice a behavioral technique known as shaping. As the patient repeats timed exercises, the therapist acts as a coach, encouraging the patient to improve each task. This positive reinforcement and one-on-one interaction is key to the success of CI therapy.   Because each patient is unique, a therapist designs a program based on the individual’s ability level and goals. Exercises simulate activities of daily living and functional tasks.   Materials used are intentionally commonplace, making it easier for patients to continue therapy on their own after returning home.
Upper Extremity: In order to prevent its use, the unaffected hand is placed in a special mitt for 90% of waking hours. The mitt encourages the use of the affected arm and, over time, “rewires” the brain. Typical exercises include stacking cups and picking up small objects.
Lower Extremity: Although the unaffected leg is not restrained, the patient must rely on the affected leg to repeatedly perform a variety of exercises designed to improve strength and coordination. Typical exercises include stepping over objects, walking at a fast pace, side-stepping, and backward walking.

Would a caregiver need to come with me to Birmingham, Alabama?
We strongly encourage patients to bring a caregiver to provide assistance and encouragement while the patient is away from the clinic.

How successful is CI Therapy as provided by the Taub Therapy Clinic?
Since opening in 2001, the Taub Therapy Clinic has proven to be one of the most effective stroke rehabilitation programs in the world.  A large majority of those who have completed the program regain significant movement and improved function.  The results have been so impressive, the Taub Therapy Clinic has been profiled by Newsweek, The New York Times, US News and World Report, USA Today, The National Geographic Channel, CNN, ABC and CBS, among others. By giving patients an individualized home program, CI therapy, as provided by the Taub Therapy Clinic, empowers patients to continue improving on their own. Patients have different ways of measuring success. For some, it means playing a musical instrument again. For others, it means walking with confidence. Or it can even be as simple as turning on a light switch with the affected hand for the first time. The bottom line: regaining movement can lead to a whole new outlook on life. CI therapy, as provided by the Taub Therapy Clinic, has also proven to have a significant impact on caregiver's lives by enabling them to return to work. A recent survey showed that 70 percent of those who gave up work to care for a family member were able to return to work after their loved one completed treatment at the Taub Therapy Clinic.