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"A study outlining the effect of CIMT on post-stroke patients."

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"A study outlining the effect of CIMT on post-stroke patients."

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Constraint induced movement therapy (CIMT) is one of the numerous therapy options for patients who have suffered from a stroke. Countless research enquiries have been undertaken to present the potential benefits or barriers that this form of therapy could provide clients. Three key themes were formed across the four papers in relation to the enquiry statement “A study outlining the effect of Constraint Induced Movement Therapy on post-stroke patients.” These themes included sample size, time and motor functions. What will be explored further within these themes are the enablers and barriers found within the four research papers by Marklund, Klassbo, and Hedelin (2010), Bonifer, Anderson, and Arciniegas (2005), Hakkennes and Keating (2005) and Barzel, Ketels, Stark, Tetzlaff, Daubman, Wegscheider, Bussche, and Scherer (2015).

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Across the globe children with cerebral palsy are suffering from learned non-use also known as developmental disregard. Constraint induced movement therapy (CIMT) is a recent method used on children, previously only known among the stroke population. Small amounts of research has been done to highlight the benefit CIMT can make on a child’s impaired upper limb as mentioned by Hamer-Rohrer, Smit and Burger (2012); Gilmore, Ziviani, Sakzewski, Shields and Boyd (2010) just to name a few. CIMT has been a treatment method in the western world since 1993 (Willard, Schell, Gillen, Scaffa, & Cohn, 2014, p.773) but since then a modified approach has been taken with components of shaping, intensive training and timing of constraint. The selection of four research papers by Gilmore et al, 2010; Hamer-Rohrer, 2012; Taub et al (2004) and Aarts et al (2012) helped develop the enquiry statement;  “Children with cerebral palsy and the effects of constraint induced movement therapy (CIMT) on the upper limb.” They used a variety methods including interviews, observations and standardized assessments to show the overall gains made by the children. The themes that were highlighted include; benefits, motivation and experience/ training, furthermore, some limitations will be explored to show a full picture of this therapy intervention.

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Across the globe children with cerebral palsy are suffering from learned non-use also known as developmental disregard. Constraint induced movement therapy (CIMT) is a recent method used on children, previously only known among the stroke population. Small amounts of research has been done to highlight the benefit CIMT can make on a child’s impaired upper limb as mentioned by Hamer-Rohrer, Smit and Burger (2012); Gilmore, Ziviani, Sakzewski, Shields and Boyd (2010) just to name a few. CIMT has been a treatment method in the western world since 1993 (Willard, Schell, Gillen, Scaffa, & Cohn, 2014, p.773) but since then a modified approach has been taken with components of shaping, intensive training and timing of constraint. The selection of four research papers by Gilmore et al, 2010; Hamer-Rohrer, 2012; Taub et al (2004) and Aarts et al (2012) helped develop the enquiry statement;  “Children with cerebral palsy and the effects of constraint induced movement therapy (CIMT) on the upper limb.” They used a variety methods including interviews, observations and standardized assessments to show the overall gains made by the children. The themes that were highlighted include; benefits, motivation and experience/ training, furthermore, some limitations will be explored to show a full picture of this therapy intervention.

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205 words

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This is one of my themes am I on the right track. AGE:Previous epidemiological studies have shown that CO-OP intervention increases activity and participation in children aged seven to twelve years (Armstrong, 2012; Taylor, Fayed, Madich, 2007; Anderson, Wilson & Williams, 2016).  Fundamental movement skills that serve as building blocks for lifelong functional movements are developed from years three to six (Chambers & Sugden, 2016).  Although refinement of these skills continues to develop, there is a rise in children starting school with poor motor development which has adverse effects on concentration, behaviour, esteem and emotions, which leads to underachieving, social isolation and a lack of physical participation (Chambers & Sugden, 2016).   Limited research of cognitive interventions has been done in the developmental stage of three to six years (Chambers & Sugden, 2016).  Children with DCD have higher levels of anxiety and lower self-efficacy, given the potential psychosocial ramifications and the impact on activity and participation, early intervention is crucial (Taylor, Fayed, Madich, 2007). The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V) states that because there is a huge variance in the acquisition of motor skills in early childhood DCD diagnoses are typically not done before age five.  In 2007 Taylor, Fayed ,& Mandich, conducted a mixed methods study which demonstrated the effectiveness of the CO-OP approach in children aged five to seven. I chose this as my fourth article because it suggested that further research with younger children was warranted however, little or no research into its utility with younger children has since been conducted (Chambers & Sugden, 2016).  

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This is one of my themes am I on the right track. AGE:Previous epidemiological studies have shown that CO-OP intervention increases activity and participation in children aged seven to twelve years (Armstrong, 2012; Taylor, Fayed, Madich, 2007; Anderson, Wilson & Williams, 2016).  Fundamental movement skills that serve as building blocks for lifelong functional movements are developed from years three to six (Chambers & Sugden, 2016).  Although refinement of these skills continues to develop, there is a rise in children starting school with poor motor development which has adverse effects on concentration, behaviour, esteem and emotions, which leads to underachieving, social isolation and a lack of physical participation (Chambers & Sugden, 2016).   Limited research of cognitive interventions has been done in the developmental stage of three to six years (Chambers & Sugden, 2016).  Children with DCD have higher levels of anxiety and lower self-efficacy, given the potential psychosocial ramifications and the impact on activity and participation, early intervention is crucial (Taylor, Fayed, Madich, 2007). The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V) states that because there is a huge variance in the acquisition of motor skills in early childhood DCD diagnoses are typically not done before age five.  In 2007 Taylor, Fayed ,& Mandich, conducted a mixed methods study which demonstrated the effectiveness of the CO-OP approach in children aged five to seven. I chose this as my fourth article because it suggested that further research with younger children was warranted however, little or no research into its utility with younger children has since been conducted (Chambers & Sugden, 2016).  

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“The effectiveness of using Constrain-induced Movement Therapy (CIMT) as a method of improving limbs function for adults (18-75 years) stroke patients” 

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“The effectiveness of using Constrain-induced Movement Therapy (CIMT) as a method of improving limbs function for adults (18-75 years) stroke patients” 

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435words 10am

Stroke also known as cardiovascular accident/disease is the third leading cause of death and disability among young adults and elderly people in New Zealand. Without proper rehabilitation approach, people are likely to live with impairment. Constraint-induced movement therapy is an intervention that aims to improve limbs functions after stroke. There are numerous studies conducted to prove the effectiveness of this intervention. There are three themes discussed across the four research papers as a response to the enquiry statement “The effectiveness of using Constrain-induced Movement Therapy (CIMT) as a method of improving limbs function for adults (18-75 years) stroke patients” (Wu, Chou, Chen, Tsai and Lin, 2007; Marklund, Klässbo and Hedelin, 2010; Lima, 2014 & Barzel et al, 2015). Themes includes quality of life, type of therapy and benefit of the therapy. These studies have highlighted the importance of conducting various….

Benefit of therapy

Being able to return function on affected limbs is view as effective training or treatment. Three of the four studies aimed to improve function (Barzel et al (2015); Wu et al (2007) & Lima (2014), and Marklund, Klässbo and Hedelin (2010) focused on evaluating whether the CIMT intervention improves function by conducting qualitative interview on people who had CIMT training. The two best studies design that are responding to the enquiry statement is qualitative by Marklund, Klässbo and Hedelin (2010) and quantitative methodology by Lima (2014). Therefore, to answer this enquiry statement mixed methodology will be employed. The research from Barzel et al (2015) investigated the importance of conducting a home-based CIMT for people who have stroke to improve their upper limbs function. Wu et al (2007) focused on measuring the changes in motor function after CIMT intervention for stroke rehabilitation. Although, Wu et al (2007) and Barzel et al (2015) adopted different approach to the intervention, both studies found that participation in home-based or modified CIMT had much improvement in performance than those in standard/traditional rehabilitation. Even though, home-based approach seemed to improve patient’s performance and function, but Lima et al (2014) stated that this approach is costly and there is a lack of financial support.

The improvement in function and performance was seen from patients who were able to performance their activity of daily living or improvement in hand movement which was the result of intensive training (Barzel et al, 2015; Lima, 2010). But, Wu et al (2007) stated that the intensive training such as mCIMT/CIMT addresses only the physical performance and it does not recognize the effect on psychosocial and cognitive domain of a person. Overall, the benefit of the therapy is to restore movement, and reduce motor impairment.

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10 Am: A study outlining effective constraint induced movement therapy (CIMT) on limbs for clients after stroke.

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10 Am: A study outlining effective constraint induced movement therapy (CIMT) on limbs for clients after stroke.

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The second most significant cause of disability in adults is stroke, which can cause the loss of functionality within both upper and lower limbs. There are a small number of therapies available to combat this loss including Constraint Induced Movement Therapy (CIMT), and will be examined in this essay through the research completed by Markund (2010), Mickeviciene (2015), Gillot (2003), and Flinn (2005). Three Themes were identified throughout the research which are motivation, functionality, and intensity of therapy. These were measured through interviews and tests completed by participants.

One of the factors contributing to the success of therapy is the participants motivation. Markund et al (2003) used qualitative methodologies to measure the level of motivation of participation during CIMT

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Constraint Induced Movement Therapy as an effective form of rehabilitation for individuals with stroke

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Constraint Induced Movement Therapy as an effective form of rehabilitation for individuals with stroke

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10am class
Introduction:  127 words
According to the World Health Organisation (2017), 15 million individuals experience stroke

each year. A common approach to minimising the impacts that stroke present is implementing constraint induced movement therapy (CIMT) on affected individuals. Research has been performed to identify the impacts CIMT has on individuals and their recovery which will be further explored in this literature review.  Four research papers have been accumulated to correspond and respond to the enquiry statement “Constraint Induced Movement Therapy as an effective form of rehabilitation for individuals with stroke”. From these four papers, the themes of Increased Performance, Improved Self-Perception and Demanding Training were identified. Although the results of these studies discuss the advantages CIMT provokes, there are limitations among the papers that will be described in further depth.

-       Need to mention the authors?

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The impact of Cognitive Orientation to Daily Occupational Performance (CO-OP) on activity and participation in children with Developmental Coordination Disorder (DCD)Cognitive Orientation to daily Occupational Performance (CO-OP) is a task orientated intervention approach, which enables skill acquisition using specific cognitive strategies, built on a child-centred model of practice (Taylor, Fayed, Madich, 2007).  This model uses child chosen goals to foster motivation and engagement while utilising the family as active participators in supporting the intervention process (Anderson, Wilson & Williams, 2016).  Some of the research papers related to my enquiry statement have highlighted the benefits of CO-OP interventions on activity and participation in children with DCD aged 7 to 12 (Mandich, Polatajko & Roger, 2003; Thornton, Licari, Reid, Armstrong, Fallows, & Elliot, 2016; Zwicker, et al., 2014) to name a few. However, a fourth article has shown the effectiveness of the CO-OP approach enhancing participation in younger children who have DCD aged from 5 to 12 years (Taylor, Fayed & Madich, 2007).  Children diagnosed with DCD have compromised motor function which negatively impacts their activity and participation in everyday settings, affecting approximately 5 – 8% of school children (Thornton et al., 2015).  The DSM-V records that males are predominantly more affected than females, with a male: female ratio of 2:1 and 7:1.  Children with DCD have higher levels of anxiety and lower self-efficacy, given the potential psychosocial ramifications and the impact on activity and participation, early intervention is crucial (Taylor, Fayed, Madich, 2007). As stated by the DSM-V, because there is a huge variance in the acquisition of motor skills in early childhood DCD diagnoses are typically not done before age five.  All the research papers excluded non-English speaking children.  I have identified three themes that will have an impact on my inquiry statement. Themes to be explored include age, gender bias and language.

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The impact of Cognitive Orientation to Daily Occupational Performance (CO-OP) on activity and participation in children with Developmental Coordination Disorder (DCD)Cognitive Orientation to daily Occupational Performance (CO-OP) is a task orientated intervention approach, which enables skill acquisition using specific cognitive strategies, built on a child-centred model of practice (Taylor, Fayed, Madich, 2007).  This model uses child chosen goals to foster motivation and engagement while utilising the family as active participators in supporting the intervention process (Anderson, Wilson & Williams, 2016).  Some of the research papers related to my enquiry statement have highlighted the benefits of CO-OP interventions on activity and participation in children with DCD aged 7 to 12 (Mandich, Polatajko & Roger, 2003; Thornton, Licari, Reid, Armstrong, Fallows, & Elliot, 2016; Zwicker, et al., 2014) to name a few. However, a fourth article has shown the effectiveness of the CO-OP approach enhancing participation in younger children who have DCD aged from 5 to 12 years (Taylor, Fayed & Madich, 2007).  Children diagnosed with DCD have compromised motor function which negatively impacts their activity and participation in everyday settings, affecting approximately 5 – 8% of school children (Thornton et al., 2015).  The DSM-V records that males are predominantly more affected than females, with a male: female ratio of 2:1 and 7:1.  Children with DCD have higher levels of anxiety and lower self-efficacy, given the potential psychosocial ramifications and the impact on activity and participation, early intervention is crucial (Taylor, Fayed, Madich, 2007). As stated by the DSM-V, because there is a huge variance in the acquisition of motor skills in early childhood DCD diagnoses are typically not done before age five.  All the research papers excluded non-English speaking children.  I have identified three themes that will have an impact on my inquiry statement. Themes to be explored include age, gender bias and language.

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The Effect of Modified Constraint Induced Movement Therapy (mCIMT) on Children with Cerebral Palsy

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The Effect of Modified Constraint Induced Movement Therapy (mCIMT) on Children with Cerebral Palsy

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Introduction - 143 words: The Starship Foundation (2017) states that there is no known cure to cerebral palsy, so it is of extreme importance to investigate different therapies to help improve the life of those living with cerebral palsy. Modified constraint induced movement therapy (mCIMT) is a child-friendly version of CIMT which has shown to be promising in improving upper limb movement in children with unilateral cerebral palsy (Eliasson & Holmefur, 2014; Rostami et al., 2012). The therapy involves training sessions in which the unaffected arm is immobilised in a sling, with the aim to for the individual to use their impaired arm (Gilmore, Ziviani, Sakzewski, Shields, & Body, 2010). Two major themes discussed in response to the enquiry statement are the benefits of the therapy, and the engaging therapy environments (Aarts et al., 2011; Eliasson & Holmefur, 2014; Gilmore et al., 2010; Rostami et al., 2012).

Start of theme 1: (Topic sentence about benefits of therapy). In childhood, cerebral palsy is the most frequent cause of physical disability (The Starship Foundation, 2017). The Cerebral Palsy Society of New Zealand (2017) states that between 0.002% and 0.0025% of live births result in a child with cerebral palsy. Even though this number is not necessarily as high as other disorders, cerebral palsy can have a major effect on the development of movement and posture, and is often accompanied by other problems with cognition, sensation, perception, communication and behaviour (Rosenbaum et al., 2007, as cited in Dodd, Imms, & Taylor, 2010).

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"The Effectiveness of Constraint-Induced Movement Therapy (CIMT) on Adults Experiencing Limb Paresis after Stroke"

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"The Effectiveness of Constraint-Induced Movement Therapy (CIMT) on Adults Experiencing Limb Paresis after Stroke"

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Constraint-induced movement therapy (CIMT) is an approach developed by Taub and Wolf  directed towards promoting the use of the affected limb to increase function through “massed practice” (Marklund, Klässbo & Hedelin, 2010) in stroke rehabilitation. Research has been undertaken focusing on how effective CIMT is towards improving coordinated movement in the affected limb, when working in stroke rehabilitation. What will be analysed is the effectiveness of CIMT as defined by (WRITE IN AUTHORS). Across the four research papers selected, two themes materialised a response to the enquiry statement “The Effectiveness of Constraint-Induced Movement Therapy on Adults Experiencing Limb Paresis After Stroke”. These two themes include Motivation and Satisfaction.

112 words

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"The Effect Of Constraint Induced Movement Therapy For Cardiovascular Accident Patients In The Affected Extremity”

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"The Effect Of Constraint Induced Movement Therapy For Cardiovascular Accident Patients In The Affected Extremity”

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Introduction: (131w)

The effects of a Cardiovascular Accident (CVA) also known as a stroke, can leave patients with life long difficulties in their physical abilities relating to their left or right sides of the body. Research has been undertaken to develop insight into new therapies for this condition such as Constraint Induced Movement Therapy (CIMT). Throughout this review, the consequences of CIMT will be identified and discussed through the research from Marklund (2010), Gillot (2003), Dettmers (2005) and Mickevičienė; 2015. The four research papers show three themes, which relate to the enquiry statement “The effect of constraint induced movement therapy for cardiovascular accident patients in the affected extremity”. These themes are rehabilitation duration, satisfaction, and quality of life (QOL). Although the papers are in favour of the advantages, the limitations will be discussed. such as*

Theme 1-  Rehabilitation duration (292w)
Formal CIMT consists of two weeks of restraint on the unaffected limb for 90% of the day, and in conjunction with six hours of exercise at a demanding pace on the affected limb (Porter & Lord, 2004).  Other forms of CIMT such as distributed CIMT, prolong the treatment over four weeks and involve less demanding daily training. This relates to the enquiry question by establishing how CIMT develops the best outcome for the affected limb. The ideal study design for this response is a mixed methods methodology.

(introduce theme)The study from Mickevičienė, Butkutė, Skurvydas, Karanauskienė and Mickevičius (2015), used a formal CIMT training, which produced significant qualitative improvement results in the affected limb. Although, the patients condition and well-being were not taken into consideration for the demand of functional use. Similarly the results from Gillot, Holder-Walls, Kurtz and Varley (2003) showed increase in performance results. However, the qualitative results from this study showed a decrease of satisfaction and belief that few functional gains were accessible due to the short duration of formal CIMT. In Dettmers, et al., (2005), a formal use of CIMT was challenging for German rehabilitation clinics. This was overcome by using distributed CIMT. The research from this study produced improvements within the first week of training. This altered the opinion of the value for formal CIMT. However it was established that maintaining training over a four-week time frame was critical for preserving the treatment effect throughout the follow up period. Throughout the studies it is identified that the intense training had a negative effect of patients satisfaction and well-being. Regardless of the formal CIMT, it is paramount that effects to well-being and satisfaction be considered. Distributed CIMT addresses these components and encourages continuous use of the affected arm, post therapy.