Case Study | Stroke Rehabilitation: Constraint Induced Movement Therapy

Author: Jamie Grant, Occupational Therapist; Director, The Occupational Therapy Hub

Setting: Stroke early supportive discharge (ESD) community team, based in the UK

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Occupational therapy assessment and intervention

I visited 'Pete' (name changed for confidentiality) regularly for 5 weeks, following and shaping his rehabilitative journey after a stroke. He engaged with an evidence-based constraint-induced movement therapy programme (CIMT). Multidisciplinary input included occupational therapy, physiotherapy, speech and language therapy and nursing.

Background

• Diagnosis: Right Temporal ICH (intra-cerebral haemorrhage); left side affected

• Dominant hand: Right hand

• Relevant past medical history: Right ICH 3 years ago

• Physical environment: 2-storey house; 1 flight of stairs, 2 rails; upstairs toilet/mowbray; upstairs bathroom (shower over bath)

• Social environment: Lives with wife, children and grandchildren live elsewhere

• Meaningful occupations: Reading; shared cooking, gardening and walking with his wife

• Ward outcome measures: Montreal Cognitive Assessment (MoCA) = 23/30 Motor Assessment Scale (MAS) = 6/18 9-hole peg test = 29 secs (right hand); left hand unable to complete

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