November 30, 2001

Motivation is key to new stroke therapy

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Brian Whitworth uses Constraint-Induced Movement Therapy with occupational therapist Jackie Houtz at Stallworth Rehabilitation Hospital to strengthen his hand mobility after a stroke. (photo by Dana Johnson)

Motivation is key to new stroke therapy

For the last five months therapists at Vanderbilt Stallworth Rehabilitation Hospital have been providing a new therapy for stroke survivors.

The procedure, Constraint-Induced Movement Therapy (CI therapy), involves putting a splint on a patient’s stronger hand, encouraging the patient to use their weaker hand for 90 percent of their activities. CI therapy usually occurs after a patient has finished traditional therapy, four months after the stroke.

“The procedure is quite a challenge,” said occupational therapist Jackie Houtz. “CI therapy helps a patient relearn everything from brushing their teeth to salting their food again.”

The procedure is designed to last for two weeks. Patients come in for at least two hours of therapy every day. The first hour is spent working on functional tasks, and the second hour is spent on traditional therapeutic activities. Patients are also encouraged to continue their therapy at home, Houtz said.

Not all stroke survivors are candidates for CI therapy. To be considered for the treatment, a patient must meet several criteria. The patient must first be able to lift a washcloth and drop it with the affected arm, and have no significant contractures. A patient must also have the cognitive ability to follow instructions and understand why and what they are doing.

“CI therapy reminded me that I do have a left arm to use,” said 28-year-old stroke survivor Brian Whitworth.

CI therapy is said to work because it overcomes a strong tendency not to use the stronger arm that was not affected by a stroke. The brain relearns simple techniques that were lost as a result of a stroke.

“CI therapy requires a high level of motivation and commitment to be able to work through the frustration and the intensity,” said Houtz.

“I wanted to be back to using my arm and doing what I did before,” said Whitworth.”Anyone who wants to be back to 100 or even 95 percent should try this treatment.”