Constraint Induced Therapy Flashcards
- What is the basis behind constraint induced therapy
Shaping: operant conditioning whereby a behavoral objective is approached (mvnt) in small steps of progressively increasing difficulty.
Participant is awarded with enthusiastic approval for improvement but never punished or blamed for failure.
Massed practice: several hours of therapy at a time
What is the traditional, non-modified protocol behind CIMT?
at least 6 month post-onset in most cases
20 degrees of extension in the wrist
10 degrees of extension in each of the fingers
ability to say at least 3 diff words spontaneously
ability to attend to a single task for at least 2 min with assist.
at least moderately intact receptive language
no more than a moderate verbal apraxia is ideal, however, clients with more servere apraxia are considered on a case by case basis- following full eval
. What are some of the outcome measures involved in CIMT
Disability- Functional independence measure, Barthel index
Arm motor fx- Wolf motor fx test, action research arm test, assessment of motor and process skills
Perceived arm motor fx- motor act. log
Arm motor impairment- Fugl Meyer assess.
Dexterity- 9 hole peg test, grooved pegboard test
Quality of life- stroke impact scale
Constraint Induced Therapy
Pt. use the weaker extremity by constraining the dominant one resulting in increased mvnt and functionality.
Teaches the brain to “rewire” itself following a stroke or brain related injury and overcome the phenomenon of learned non-use.
TX= 6 hours a day, 5 days a week for 2-3wks (need physical stamina)
-always address hemiparetic side, even just to stabilize
find fx for it whenever possible
What kind of patient might benefit from the CIT approach
motivated, 6 months post stroke, endurance to make it through long sessions.
Different kinds of activities patients do?
CIMT: restraint of unaffected UE with > 3 hrs therapy/day (sling or splint in place for 90% of waking hours during usual ADL’s or exercises)
mCIMT (modified)- restraint of unaffected UE with 3 hours or < therapy/day
FU(forced use)- restraint of unaffected UE with no specific tx of affected UE
(sit on hand, mitt, sling)
what kinds of activities might patients do?
Gross Motor- ball catching, twisting lid of jars, lift and place large objects in shopping bag, stack cans, open doors
Fine motor tasks- Sort and stack change, pick up paper clips, manipulate buttons/zippers, play piano, board games, use can opener, use key to open door.
FX tasks- cooking, household tasks (cleaning, wiping, loading dishwasher, ironing, folding clothes), maintenance tasks w tools, vacuuming, mopping, sweeping, dusting.
