Modified Constraint-Induced Movement Therapy for Elderly Clients With Subacute Stroke

Author:

McCall Martha1,McEwen Sara2,Colantonio Angela3,Streiner David4,Dawson Deirdre R.5

Affiliation:

1. Martha McCall, MScOT, is Occupational Therapist, Kunin–Lunenfeld Applied Research Unit, Baycrest, Toronto, Ontario, and was Student, Graduate Department of Rehabilitation Sciences, University of Toronto, Ontario, at the time of the study

2. Sara McEwen, PT, PhD, is Scientist, St. John’s Rehab Hospital, Toronto, Ontario, and Assistant Professor, Department of Physical Therapy, University of Toronto, Ontario

3. Angela Colantonio, PhD, OT Reg (ON), is Professor, Graduate Department of Rehabilitation Sciences and Department of Occupational Science and Occupational Therapy, University of Toronto, Ontario, and Senior Research Scientist, Toronto Rehabilitation Institute, Toronto, Ontario

4. David Streiner, PhD, CPsych, is Professor, Department of Psychiatry, University of Toronto, Ontario, and Professor Emeritus, Department of Clinical Epidemiology and Biostatistics and Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario

5. Deirdre R. Dawson, PhD, OT Reg (ON), is Senior Scientist, Rotman Resarch Institute, Baycrest, Toronto, Ontario, and Associate Professor, Graduate Department of Rehabilitation Sciences and Department of Occupational Science and Occupational Therapy, University of Toronto, 3560 Bathurst Street, Toronto, ON M6A 2E1, Canada ddawson@klaru-baycrest.on.ca

Abstract

Abstract A growing body of research, including evidence from numerous randomized controlled trials, suggests that constraint-induced movement therapy (CIMT) reduces impairment. The mean age of participants in most studies has been <65 yr, even though most stroke survivors are older than that. We investigated the efficacy of a modified CIMT protocol on participation, activity, and impairment in a population of older adults experiencing subacute stroke. Using an interrupted time series design, 4 older adults (mean age = 82) were assessed before and after intervention. Although none of the participants adhered to the 6-hr per day self-practice aspect of the CIMT protocol, considerable improvements were noted in participation, as measured using the Canadian Occupational Performance Measure. Some improvements were also noted at the level of impairment and activity. This work accords with previous literature on CIMT and has important implications for the evolution of stroke rehabilitation in elderly people.

Publisher

AOTA Press

Subject

Occupational Therapy

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