The social organization in constraint-induced movement therapy.
Ethnographic data were collected at two rehabilitation facilities conducting ongoing research to evaluate functional and neurological outcomes of constraint-induced movement therapy (CIMT). Our findings indicate that several patterns of behavior occur during participant/therapist interaction in therapy sessions: coaching, cheerleading, reminding, changing, and contemplating. These interaction patterns indicate that learned nonuse of an affected limb does not exist in social isolation and that people who participate in CIMT routinely consider the balance of any improvement against the costs of using an affected limb that is still not fully functional. These patterns of social interaction that occur during therapy--which often influence a participant's hope for future physical progress--are an important part of CIMT that may not be fully acknowledged in the clinical training of therapists.
Boylstein
Craig
C
Rehabilitation Outcomes Research Center, North Florida/South Georgia VA Medical Center, Gainesville, FL 32608, USA. Craig.Boylstein@med.va.gov
Rittman
Maude
M
Gubrium
Jaber
J
Behrman
Andrea
A
Davis
Sandra
S
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001290:Attitude; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy / Q000379:methods / Q000523:psychology; D026741:Physical Therapy Modalities / Q000523:psychology; D011369:Professional-Patient Relations; D020127:Recovery of Function; D012149:Restraint, Physical; D012961:Sociology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome