Adherence to modified constraint-induced movement therapy: the case for meaningful occupation

INTRODUCTION: Modified constraint-induced movement therapy (mCIMT) has been shown to improve function of an affected upper limb post stroke. However, factors influencing adherence of individuals undertaking a mCIMT protocol require further investigation. AIM: To explore the experience of two participants undergoing a mCIMT protocol and examine factors influencing adherence to the protocol. METHODS: A qualitative case study design was used. Two participants with upper limb hemiparesis following a stroke were recruited and received mCIMT (two hours of therapy, three days per week for a total of two weeks). During the treatment period, participants were also encouraged to wear the restraint mitt for four hours per day at home. RESULTS: Participants reported increased confidence and self-esteem following participation, as well as improvements in bi-lateral upper limb function. Participants reported the mCIMT protocol as being highly frustrating. However, motivation to adhere to the protocol was positively influenced by the meaningfulness of the occupations attempted. CONCLUSION: Although mCIMT can prove frustrating, meaningful occupations may act as a powerful motivator towards adherence to a mCIMT protocol. Further research is required.