Group modified constraint-induced movement therapy (mCIMT) in a clinical setting

Abstract

Purpose: We evaluated the effectiveness of a modified constraint-induced movement therapy (mCIMT) program delivered in a group format. Methods: Thirteen subacute or chronic stroke and two subacute brain injured participants attended a group mCIMT program for 3.5 h daily for 10 treatment days. The groups consisted of three participants supervised by two staff. Motor recovery, functional arm use, and participation were evaluated by an independent assessor at five time points (baseline, immediately preprogram, immediately postprogram, 1 and 3-month postprogram). Results:Participants achieved statistical and clinically significant improvements in motor recovery (Wolf Motor Function Test), functional use (Motor Activity Log) and participation (Canadian Occupational Performance Measure). These improvements were maintained over a 3-month follow-up period. Conclusion: Group delivery of mCIMT produces meaningful results and is a potentially effective way of extending availability of this program without placing overwhelming demands on health care resources.

Implications for Rehabilitation

• Constraint-induced movement therapy (CIMT) is an effective treatment for upper extremity weakness as a result of stroke or brain injury.

• Development of CIMT programs in a clinical setting have been limited by the heavy demands it places on personnel, space and equipment

• A clinically based group modified CIMT (mCIMT) program with stroke and brain injury survivors showed statistically significant and clinically relevant improvements in motor recovery, functional use, and participation.

• Group delivery of mCIMT can be an effective way of extending availability of this program without placing overwhelming demands on hospital resources.

Keywords::

• Occupational therapy
• rehabilitation
• stroke
• upper extremity

Acknowledgements

We would like to thank the Glenrose Rehabilitation Hospital’s Outpatient Stroke Program and Occupational Therapy Service, particularly Linda Cameron and Rhondda Jones.

Declaration of Interest: This work was supported by a grant from the Glenrose Rehabilitation Hospital Foundation’s Clinical Research Fund and the first author was supported in part by a scholarship from the University of Alberta, Faculty of Graduate Studies and Research.