CIMT, BWST, ASAP

Question 1

BWST

The amount of support is determined by

Answer 1

how much support the patient needs to move against gravity, allowing for movement of LEs

Question 2

what is the Modified Constraint Induced Movement Therapy?

Answer 2

• is a less intense protocol than original CIMT;
• 30 min sessions instead of 3-6 hours.
• And restraining 5 hours per day instead of 90% of wake hours.

Question 3

what is Accelerated Skill Acquisition Program?

Answer 3

• Uses skill, capacity, and motivation
• Combination of task-specific and skill-based/impairment-mitigating training with embedded patient-centered motivational enhancements

Question 4

✍🏼

BWST progression parameters

Answer 4

• Decrease amount of BWS
  
  • 40% to 30% to 20% no BWS
• Decrease amount of manual guidance
• Increase walking speed
• Increase incline
• Increase duration per session

Question 5

BWST strategies:

Answer 5

1. Standing training: determine amount of BWS Use of UE’s discouraged.
2. Step training: manual guidance as needed, focus on kinematics of stepping pattern.
3. Step adaptability training: progress speed, incline, duration.
4. Overground walking training
5. Community integration

Question 6

✅

Rationale for Constraint Induced Movement Therapy: two mechanisms

Answer 6

1. Overcome learned non-use
2. Use-dependent brain (cortical) plasticity:
   
   • Massed practice and use of the involved extremity
   • Learned phenomenon
   • Specificity, carry-over

Question 7

What are the three main elements of the CIMT protocol?

Answer 7

1. Repetitive, task-oriented training (of the impaired UE):
   
   • Shaping
   • Task practice
2. Adherence
3. Constraining

Question 8

Intervention period of CIMT

Answer 8

3-6 hours, 10-15 consecutive days

Question 9

CIMT

What is shaping?

Answer 9

• Behavioral training
• Task is slowly progressed
• Positive reinforcement

Question 10

accelerated skill acquisition program conceptual framework: integration of

Answer 10

1. SKILL (Motor learning and self-management)
2. CAPACITY (Impairment mitigation)
3. MOTIVATION (Intrinsic drive)

Question 11

ACCELERATED SKILL ACQUISITION PROGRAM

The ASAP is a hybrid combination of _______ and _________with embedded patient-centered motivational enhancements.

Answer 11

1. task-specific
2. skill-based/impairment-mitigating training

Question 12

ASAP based based on

Answer 12

• motor learning
• neuroscience
• behavioral science research

Question 13

Accelerated Skill Acquisition Program principles

Answer 13

1. Ensure challenging and meaningful practice
2. Address important (interfering) changeable impairments
3. Enhance motor capacity through overload and specificity
4. Preserve natural, goal-directedness in movement organization
5. Avoid artificial task breakdowns when possible
6. Ensure active patient involvement and opportunities for self-direction
7. Balance immediate and future needs
8. Drive task-specific self-confidence high through performance accomplishments