Adult experiences of constraint-induced movement therapy programmes : A qualitative study using the Theoretical Domains Framework and Capability, Opportunity, Motivation - Behaviour system

Journal article


Christie, Lauren J., Rendell, Reem, McCluskey, Annie, Fearn, Nicola, Hunter, Abigail and Lovarini, Meryl. (2022). Adult experiences of constraint-induced movement therapy programmes : A qualitative study using the Theoretical Domains Framework and Capability, Opportunity, Motivation - Behaviour system . Brain Impairment. 24(2), pp. 274-289. https://doi.org/10.1017/BrImp.2022.18
AuthorsChristie, Lauren J., Rendell, Reem, McCluskey, Annie, Fearn, Nicola, Hunter, Abigail and Lovarini, Meryl
Abstract

Aim:
To explore the experiences of adults who completed a constraint-induced movement therapy (CIMT) programme, and the barriers and enablers to their participation.

Methods:
Qualitative design using semi-structured interviews. Stroke and brain injury survivors (n = 45) who had completed CIMT as part of their usual rehabilitation were interviewed 1 month post-CIMT. Interviews were audio-recorded, transcribed and imported into Nvivo for analysis. Inductive coding was used to identify initial themes. Themes were then deductively mapped to the Capability, Opportunity, Motivation – Behaviour system, a behaviour change model, to identify barriers and enablers to CIMT programme adherence and engagement.

Results:
Enablers influencing participation included being provided with education about the programme (Capability – psychological), seeing improvements in arm function (Motivation – reflective), being committed to the programme (Motivation – reflective) and having strong social support from staff, family and allied health students (Opportunity – social). The structured programme was a motivator and offered a way to fill the time, particularly during inpatient rehabilitation (Opportunity – physical). Barriers to participation included experiencing physical and mental fatigue (Capability – physical) and frustration early in the CIMT programme (Motivation – automatic), and finding exercises boring and repetitive (Motivation – automatic).

Conclusion:
Therapist provision of educational supports for CIMT participants and their families is important to maximise CIMT programme uptake. During CIMT delivery, we recommend the provision of positive feedback and coaching in alignment with CIMT principles, and the inclusion of social supports such as group-based programmes to enhance participant adherence.

Keywordsstroke; traumatic brain injury; rehabilitation; adherence; constraint-induced therapy; participation
Year2022
JournalBrain Impairment
Journal citation24 (2), pp. 274-289
PublisherCambridge University Press
ISSN1443-9646
Digital Object Identifier (DOI)https://doi.org/10.1017/BrImp.2022.18
Scopus EID2-s2.0-85143355531
Open accessPublished as ‘gold’ (paid) open access
Page range274-289
FunderMinistry of Health, New South Wales
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online24 Aug 2022
Publication process dates
Accepted06 Jul 2022
Deposited20 Dec 2023
Grant IDProject number 28
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