Can you use constraint induced motor treatment in skilled nursing settings?
Answer
I have heard about many studies on constraint induced motor treatment (CIMT) being done in skilled nursing settings and in long-term care facilities. Keep in mind with these principles that the older brain tends not to be as plastic as younger clients. What I have found in skilled nursing or long-term care facilities is an interdisciplinary team approach with every profession utilizing the CIMT concepts is most effective. For example, every time anybody is around the client, they encourage them to use their affected arm and hand. This also includes family members and any other visitors. This needs to be reinforced 24/7.
An interesting way I saw this implemented in one facility was that the therapist would identify clients that they felt were appropriate for CIMT by tying a certain color ribbon onto the back of their wheelchair, walker, or whatever. This would indicate to everybody in the facility that this person was using CIMT so that everyone could encourage the person to use their affected arm and hand during ADLs and other activities. The simple idea of a colored ribbon was a very powerful visual cue.
Veronica T. Rowe, PhD, OTR/L, CBIST
Dr. Veronica Rowe has over 24 years of experience as an occupational therapist, she has worked in various areas of adult and geriatric care including acute care, inpatient and outpatient rehabilitation, long term care, burns, hands, and psychiatric care, all areas with an emphasis in neurological disorders. Prior to her work in academia, she spent her career in St. Louis, Missouri at St. Anthony’s Medical Center; Baltimore, Maryland at Johns Hopkins Bayview; and Atlanta, Georgia at Emory University. She served as a project coordinator for numerous research studies at Emory University involving rehabilitation therapies for the neurologically compromised upper extremity, including constraint induced movement therapy, mental imagery, and use of robotic devices. She has collaborated on several research studies involving task-specific training and neurorehabilitation assessment measures with the University of Southern California. She is the author of numerous peer-reviewed articles, and has presented nationally, internationally, and virtually for a wide variety of audiences. She is also a Certified Brain Injury Specialist Trainer. She has over 13 years of experience teaching in occupational therapy at the University of Central Arkansas and Georgia State University. She currently teaches and mentors research and neurological rehabilitation courses in occupational therapy.
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