Rehabilitation
Clients can utilise their own resources – this would be identified in the planning stages of the mCIMT and may include items such as : Connect 4 , pegs , buttons , a deck of cards , children ’ s toys and playdough .”
Rehabilitation
The mitt needs to be easily removed for hygiene / water tasks and so not classed as a form of ‘ restraint ’. If a walking aid is to be used , then the client would potentially not be appropriate for mCIMT , unless this was removed for the purpose of walking / ascending / descending stairs .
Following risk assessment , the client is provided with a list of activities where they are permitted to remove the mitt , and this also includes toileting . This is provided prior to mCIMT commencing , along with other screening forms .
The outcome measures used suggested that , over the duration of the mCIMT , my client began to use the affected arm in more activities , therefore changing behaviours and including it more within day-to-day function outside of the mCIMT programme
The scores on the MAL also suggested that tasks became easier , as the weeks progressed , with more accuracy and speed reported by the patient . It is important to note that the MAL is subjective to the client and there can be variability in the ratings .
Measures also indicating increased functional ability with the tasks , such as using the arm for transfers and dressing ,
After two weeks , the client resumed their existing one-to-one rehabilitation and had met some of their goals , such as being able to brush their own hair . They reported feelings of increased motivation and satisfaction ; this further prompted them to identify some other goals and to continue applying some of the mCIMT principles and tasks in their existing day-to-day rehabilitation programme .
They were well set up in the bedroom upstairs to be able to continue some of the shaping activities , utilising their own resources .
It is important to consider that motivation and compliance are huge factors and potential barriers to the application and success of mCIMT , and the programme is a big responsibility for clients to take on .
Improvements in outcome measures may be small , however it is important to note that it is more prudent to achieve long-term behavioural changes – often this can continue long after the programme has ceased .
There is nothing to suggest that mCIMT cannot be repeated , if clinically indicated . It is important to highlight when the mitt can be removed and have this documented and provided to the client , for safety purposes .
Clients can utilise their own resources – this would be identified in the planning stages of the mCIMT and may include items such as : Connect 4 , pegs , buttons , a deck of cards , children ’ s toys and playdough .
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Taub E and Uswatte G ( 2009 ). Constraint- Induced Movement Therapy : A paradigm for translating advances in behavioural neuroscience into rehabilitation treatments . DOI : 10.1002 / 9780470478509 . neubb002066 .
Clients can utilise their own resources – this would be identified in the planning stages of the mCIMT and may include items such as : Connect 4 , pegs , buttons , a deck of cards , children ’ s toys and playdough .”
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Words NATALIE WRIGHT , Specialist Occupational Therapist , The Walton Centre NHS Foundation Trust . For any mCIMT queries or for sharing of resources , please contact natalie . wright38 @ nhs . net
June 2023 OTnews 49