Purpose This study aimed to verify whether modified constraint induced movement therapy combined with anticipatory postural adjustments improve corticospinal tract in hemiplegic patients. Methods Nine hemiplegic patients after stroke performed a shaping exercise which consists of Modified Constraint Induced Movement therapy (mCIMT) combined with Anticipatory Postural Adjustments (APAs) for 30 minutes per day, 5 days a week, for 4 weeks. And, the subjects were tested with Motor Activity Log (MAL) and Diffusion Tensor Imaging (DTI) before and after the intervention. Results The amount of use in MAL (MAL AOU, and Unit, core) increased from 32.00 ± 32.04 to 65.25 ± 23.63 with a significant difference. The quality of movement in MAL (MAL QOM, and Unit, score) increased from 55.63 ± 21.18 to 81.88 ± 12.69 with a significant difference. And, the score of the volume of DTI (Unit, mm3) increased from 63.80 ± 40.63 to 120.80 ± 115.16. Conclusion the changes in the tract volume showed improvement in structure of the brain and upper limb function, which is resulted from the neuroplasticity. Therefore, mCIMT and APAs can improve Corticospinal tract (CST) through neuroplasticity and helpful in brain structure and upper limb function.