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Journal of Primary Health Care Journal of Primary Health Care Society
Journal of The Royal New Zealand College of General Practitioners
RESEARCH ARTICLE (Open Access)

Adherence to modified constraint-induced movement therapy: the case for meaningful occupation

Johanne Walker 1 , Melanie Moore 1 2
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1 School of Health and Social Development, Deakin University, Geelong, Australia

2 Latrobe Community Health Service, Gippsland, Australia

Correspondence to: Johanne Walker, Deakin University, Locked Bag 20001, Geelong, Vic. 3220, Australia. Email: johanne.walker@deakin.edu.au

Journal of Primary Health Care 8(3) 263-266 https://doi.org/10.1071/HC16022
Published: 20 September 2016

Journal Compilation © Royal New Zealand College of General Practitioners 2016.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Abstract

INTRODUCTION: Modified constraint-induced movement therapy (mCIMT) has been shown to improve function of an affected upper limb post stroke. However, factors influencing adherence of individuals undertaking a mCIMT protocol require further investigation.

AIM: To explore the experience of two participants undergoing a mCIMT protocol and examine factors influencing adherence to the protocol.

METHODS: A qualitative case study design was used. Two participants with upper limb hemiparesis following a stroke were recruited and received mCIMT (two hours of therapy, three days per week for a total of two weeks). During the treatment period, participants were also encouraged to wear the restraint mitt for four hours per day at home.

RESULTS: Participants reported increased confidence and self-esteem following participation, as well as improvements in bi-lateral upper limb function. Participants reported the mCIMT protocol as being highly frustrating. However, motivation to adhere to the protocol was positively influenced by the meaningfulness of the occupations attempted.

CONCLUSION: Although mCIMT can prove frustrating, meaningful occupations may act as a powerful motivator towards adherence to a mCIMT protocol. Further research is required.

KEYWORDS: Stroke; meaningful occupation; motivation; upper extremity; motor skills; constraint-induced movement therapy


References

[1]  World Health Organization. Global status report on noncommunicable diseases. Geneva: WHO; 2014. [cited 2016 Jan 18]. Available from: www.who.int/nmh/publications/ncd-status-report-2014/en/

[2]  Silva SM, Correa FI, Faria CD, et al. Evaluation of post-stroke functionality based on the International Classification of Functioning, Disability, and Health: a proposal for use of assessment tools. J Phys Ther Sci. 2015; 27 1665–70.
Evaluation of post-stroke functionality based on the International Classification of Functioning, Disability, and Health: a proposal for use of assessment tools.Crossref | GoogleScholarGoogle Scholar | 26180294PubMed |

[3]  Langhorne P, Coupar F, Pollock A. Motor recovery after stroke: a systematic review. Lancet Neurol. 2009; 8 741–54.
Motor recovery after stroke: a systematic review.Crossref | GoogleScholarGoogle Scholar | 19608100PubMed |

[4]  Page SJ, Levine P, Sisto S, et al. Stroke patients’ and therapists’ opinions of constraint-induced movement therapy. Clin Rehabil. 2002; 16 55–60.
Stroke patients’ and therapists’ opinions of constraint-induced movement therapy.Crossref | GoogleScholarGoogle Scholar | 11837526PubMed |

[5]  McCall M, McEwen S, Colantonio A, et al. Modified constraint-induced movement therapy for elderly clients with subacute stroke. Am J Occup Ther. 2011; 65 409–18.
Modified constraint-induced movement therapy for elderly clients with subacute stroke.Crossref | GoogleScholarGoogle Scholar | 21834456PubMed |

[6]  Treger I, Aidinof L, Lehrer H, et al. Modified constraint-induced movement therapy improved upper limb function in subacute poststroke patients: a small-scale clinical trial. Top Stroke Rehabil. 2012; 19 287–93.
Modified constraint-induced movement therapy improved upper limb function in subacute poststroke patients: a small-scale clinical trial.Crossref | GoogleScholarGoogle Scholar | 22750958PubMed |

[7]  Wu CY, Tsai W, Lin K, et al. A randomized controlled trial of modified constraint-induced movement therapy for elderly stroke survivors: changes in motor impairment, daily functioning and quality of life. Arch Phys Med Rehabil. 2007; 88 273–8.
A randomized controlled trial of modified constraint-induced movement therapy for elderly stroke survivors: changes in motor impairment, daily functioning and quality of life.Crossref | GoogleScholarGoogle Scholar | 17321816PubMed |

[8]  Earley D, Herlache E, Skelton DR. Use of occupations and activities in a modified constraint-induced movement therapy program: a musician’s triumph over chronic hemiparesis post stroke. Am J Occup Ther. 2010; 64 735–44.
Use of occupations and activities in a modified constraint-induced movement therapy program: a musician’s triumph over chronic hemiparesis post stroke.Crossref | GoogleScholarGoogle Scholar | 21073104PubMed |

[9]  Engel JM. Evaluation and pain management, Chapter 27. In: HM Pendelton, W Schultz-Krohn, eds. Pedretti’s occupational therapy: practice skills for physical dysfunction, 6th ed. St. Louis, MI: Mosby; 2006. p. 646–55.

[10]  Ikiugu MN, Hoyme AK, Mueller BA, et al. Meaningful occupation clarified: thoughts about the relationship between meaningful and psychologically rewarding occupations. S Afr J Occup Ther. 2015; 45 47–50.
Meaningful occupation clarified: thoughts about the relationship between meaningful and psychologically rewarding occupations.Crossref | GoogleScholarGoogle Scholar |

[11]  Dedding C, Cardol M, Eyssen IC, et al. Validity of the Canadian Occupational Performance Measure: a client-centred outcome measurement. Clin Rehabil. 2004; 18 660–7.
Validity of the Canadian Occupational Performance Measure: a client-centred outcome measurement.Crossref | GoogleScholarGoogle Scholar | 15473118PubMed |

[12]  Rubin HJ, Rubin IS. Qualitative interviewing: the art of hearing data. Thousand Oaks, USA: Sage Publications; 2011.