Background and Aims: Constraint-induced movement therapy (CIMT) is effective for arm recovery post-stroke, however there are barriers to its use in practice. Barriers include stroke survivors accessing daily face to face appointments, lack of clinician time and knowledge. We aimed to evaluate the feasibility and acceptability of delivering CIMT via telehealth (TeleCIMT) to address these barriers.
Methods: Prospective mixed methods, single blinded design. Adult stroke survivors with mild to moderate upper limb impairment were recruited from four outpatient clinics. They received a 3 week, semi-supervised TeleCIMT program delivered within usual care. Therapists were supported by an implementation package designed using the Behaviour Change Wheel. Baseline, post-intervention and one month follow-up outcomes were recorded. Acceptability was evaluated through participant interviews. Data were analysed using inferential statistics and thematic analysis.
Results: Nineteen participants were recruited; 18 completed post-program measures. Most participants (n=15, 83.3%), completed >80% of planned intervention (> 24 hours of practice). Participants demonstrated significant improvements on the Action Research Arm Test (MD 6.3, 95%CI 2.2-10.4), Box and Block Test (MD 5 blocks, 95%CI 1.9-7.4) and self-reported amount of use and quality of arm movement (AoU MD 0.8, 95%CI 0.5-1.1; QoM MD 0.6, 95%CI 0.3-1.0; all p<0.05). TeleCIMT was acceptable to stroke survivors, with access to therapist coaching identified as being essential to maintain motivation.
Conclusion: TeleCIMT may address inequities in accessing evidence-based stroke rehabilitation. It is feasible in practice and acceptable to stroke survivors.