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.
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Veronica T. Rowe, PhD, OTR/L
Veronica Rowe, PhD, OTR/L, is a tenured associate professor at Georgia State University in Atlanta, Georgia. She has been an OT for 29 years, during which time she worked clinically in various areas of adult care and has been involved with multiple large clinical research trials. She is also a Certified Brain Injury Specialist Trainer. She has spent the last 15 years teaching in OT schools and pursuing her research interests in adult neurorehabilitation after stroke or other brain injury. Her research is ongoing with multiple funded projects and resultant publications.
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