Modified Constraint-Induced Movement Therapy for persons with unilateral upper extremity amputation: A case report.

STUDY

DESIGN

Pretest/posttest case series design.

INTRODUCTION

Rates of prosthetic device abandonment are highest among persons with upper extremity (UE) amputation. Modified Constraint-Induced Movement Therapy (mCIMT), which has been extensively studied in patients with chronic, subacute, and acute stroke, is an under-utilized approach to treat persons with UE amputation.

PURPOSE OF THE STUDY: To present an mCIMT intervention for prosthetic device training after a unilateral UE amputation.

METHODS

The two cases from an advanced rehabilitation center herein described followed a standard UE amputation rehabilitation program used in conjunction with a home training program using mCIMT 3 hours a day, 5 days a week, for 3 weeks. Progress was evaluated weekly using the Activities Measure for Upper Limb Amputees (AM-ULA); Disabilities of the Arm, Shoulder, and Hand; Trinity Amputation and Prosthesis Experience Scales-Revised.

RESULTS

Both the cases exhibited an increase in observable and objective functional use with a UE prosthetic device, as indicated by the AM-ULA.

CONCLUSIONS

To our knowledge, this is the first description of mCIMT as part of a unilateral UE amputee rehabilitation program. The AM-ULA results show meaningful change, whereas Disabilities of the Arm, Shoulder, and Hand and Trinity Amputation and Prosthesis Experience Scales-Revised show mixed results.