Perspective of occupational therapists, physiotherapists and patients on the conventional and innovative methods of Constraint-induced movement therapy in the Czech Republic

Abstract

The comprehensive therapeutic programme Constraint-induced movement therapy (CIMT) focuses on functional training of the paretic upper limb and the transfer of acquired skills in daily life. Based on existing research, one way to increase accessibility of the intervention is using information and communication technologies. The aim of the survey was to map the current experience of occupational therapists, physiotherapists and patients with the CIMT therapeutic toolkit and home activity monitoring. The components of CIMT currently used, the forms of monitoring, the barriers to CIMT provision, and the motivations and subjectively perceived limitations for the use of technology in rehabilitation for activity monitoring were explored. Czech therapists reported the most common perceived barriers that limit CIMT provision as follows: low number of suitable patients, lack of knowledge about the method, increased administrative and time demands, or concerns about the high demands of the method for patients. Patients themselves are then limited in participating in the programme due to its low accessibility (having to commute or not meeting the indication criteria) or fear of the high difficulty of the exercise. According to the survey results, patients with upper limb paresis after brain injury as well as therapists are motivated to participate in remote therapy and share home exercise results remotely (via email, mobile or web application, or using sensors). The present work aims to increase awareness of innovative CIMT practices and activity monitoring to improve its accessibility and potentially reduce its costs in clinical practice.