Implementing constraint-induced movement therapy into practice in sub-acute stroke: Experiences and perceptions of stroke survivors and therapists

Jarvis, Kathryn; Edelstyn, Nicky; Hunter, Susan

Abstract

Introduction:
Constraint-induced movement therapy has been shown to be effective in a sub-group of sub-acute stroke survivors but has not been widely implemented in the United Kingdom. This study explored therapist and stroke survivor perceptions and experiences of constraint-induced movement therapy and explored the non-agreement (incongruence) and agreement (congruence) of these perspectives.

Method:
Consenting occupational therapists (n = 3) and physiotherapist (n = 5) participated in a focus group discussion. Four-stroke survivors undertook pre- and post-constraint-induced movement therapy interviews. Stroke survivor participants selected and undertook an evidence-based constraint-induced movement therapy protocol. Focus groups and interview audio recordings were independently analysed thematically. Therapist and stroke survivor views were subsequently synthesised using meta-ethnographic principles.

Findings:
Four over-arching themes were identified: motivation and determination to participate in constraint-induced movement therapy; who benefits; which protocol; making constraint-induced movement therapy feasible. The final over-arching theme comprised five sub-themes: fatigue and sleep; pain; transport; need for support; training, support and mentorship for therapists. Stroke survivors and therapists held contrasting views on three themes.

Conclusion:
Participating stroke survivors successfully undertook a self-selected, evidence-based constraint-induced movement therapy protocol. The identified enablers and barriers should inform future constraint-induced movement therapy protocol development. The contrasting views held by therapists and stroke survivors reinforce the need for collaborative communication and opportunity for choice during constraint-induced movement therapy.

Citation

Jarvis, K., Edelstyn, N., & Hunter, S. (2024). Implementing constraint-induced movement therapy into practice in sub-acute stroke: Experiences and perceptions of stroke survivors and therapists. British Journal of Occupational Therapy, https://doi.org/10.1177/03080226241261183

• Journal Article Type: Article
• Acceptance Date: May 23, 2024
• Online Publication Date: Jul 26, 2024
• Publication Date: Jul 26, 2024
• Deposit Date: Jun 18, 2024
• Publicly Available Date: Aug 9, 2024
• Journal: British Journal of Occupational Therapy
• Print ISSN: 0308-0226
• Electronic ISSN: 1464-5165
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1177/03080226241261183
• Keywords: constraint-induced movement therapy; stroke rehabilitation; upper limb; implementation; therapy; qualitative
• Public URL: https://keele-repository.worktribe.com/output/852721