Therapy Duration: 3 Versus 6 Hours per Day
In this case series, we found that a shortened version of the CIMT is a feasible and tolerable intervention for individuals with longstanding UE dysfunction due to hemispherectomy. A shortened intervention scheme also was particularly appropriate for our patients, who had decreased mental ages and limited ability to sustain motivation.
Most of the current literature on CIMT has focused specifically on the adult population. Two groups of authors, however, used a more “traditional” CIMT delivery for pediatric clients. DeLuca et al5 reported on their use of CIMT in children with an average age of 3.25 years. Karman et al14 investigated the use of CIMT for hemiplegic children with acquired brain injuries whose average age was 12.5 years. Similar to our case series, they also had a small sample size (N=7) and reported significant improvements in all patients. After careful consideration of the specifics of our patients, we decided to follow the suggestions of a report of 3 case studies of adults, which indicated that 3 hours of CIMT significantly improved motor function in individuals with chronic stroke.27 These authors concluded that 6 hours a day of CIMT may have caused frustration, boredom, or undue fatigue for their patients, translating to a decreased capacity for motor learning.28,29 In retrospect, we believe that a 3-hour intervention was an appropriate duration for our patients because of their mental and psychological disabilities
Therapy Duration: 3 Versus 6 Hours per DayIn this case series, we found that a shortened version of the CIMT is a feasible and tolerable intervention for individuals with longstanding UE dysfunction due to hemispherectomy. A shortened intervention scheme also was particularly appropriate for our patients, who had decreased mental ages and limited ability to sustain motivation.Most of the current literature on CIMT has focused specifically on the adult population. Two groups of authors, however, used a more “traditional” CIMT delivery for pediatric clients. DeLuca et al5 reported on their use of CIMT in children with an average age of 3.25 years. Karman et al14 investigated the use of CIMT for hemiplegic children with acquired brain injuries whose average age was 12.5 years. Similar to our case series, they also had a small sample size (N=7) and reported significant improvements in all patients. After careful consideration of the specifics of our patients, we decided to follow the suggestions of a report of 3 case studies of adults, which indicated that 3 hours of CIMT significantly improved motor function in individuals with chronic stroke.27 These authors concluded that 6 hours a day of CIMT may have caused frustration, boredom, or undue fatigue for their patients, translating to a decreased capacity for motor learning.28,29 In retrospect, we believe that a 3-hour intervention was an appropriate duration for our patients because of their mental and psychological disabilities
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