Modifying constraint induced movement therapy for diverse populations

Aims: This paper aims to describe a modified constraint induced movement therapy (mCIMT) protocol used within a comprehensive interdisciplinary day rehabilitation program for a multi-needs population, propose a methodology for selecting participants for this protocol, describe the collaboration between professions within this intervention protocol, and provide a case report of outcomes of 5 participants. Methods: In this retrospective chart review of participants enrolled in an interdisciplinary outpatient rehabilitation program, 5 participants met inclusion criteria of an average of at least 30 min of mCIMT each day and at least 10 days of casting during admission. Assessment measures and classification scales included the Canadian Occupation Performance Measure, Manual Ability Classification Scale, Gross Motor Function Classification Scale, Quality of Upper Extremity Skills Test, Assisting Hand Assessment and Mini-Assisting Hand Assessment. Results: Improvement was observed for all participants across all measures. Exploratory analysis revealed significant change from pre-to post-intervention on the COPM in both average performance (p < .05) and overall satisfaction (p < .05). Significant improvement across time points was also seen on the QUEST (p < .05). Conclusions: This modification of an effective intervention for children with cerebral palsy gives children who have a lower baseline skill set or who have additional mobility, communication, and cognitive needs the opportunity to receive intensive upper extremity training.