Is shoulder pain or pain as a result of spasticity a contraindication for CIMT?
Answer
Yes. You certainly want to assess a client’s pain at all times. Because of the repetitive nature of CIMT, it might be a contraindication for someone with shoulder pain. As we all know with a stroke or compromised shoulder due to a neurological incident, pain is not gain, and we want to be very mindful. In the EXCITE trial, that was one of the qualifiers, that a person did not exhibit any pain or had minimal pain. The protocol could be altered so that they would be allowed rest periods or the activity modified to increase participation. You would definitely want to monitor and accommodate for it as able.
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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