The Role of Caregiver in Modified Constraint Induced Movement Therapy in Uasin-Gishu County, Kenya

Constraint induced movement therapy (CIMT) is an effective rehabilitative intervention for motor recovery of the affected upper extremity in post stroke patients. However, this concept is not directly applicable in a resource scarce setting. Using the principle of CIMT in the patients' home utilizing a trained caregiver can modify this. The aim of this study was therefore to determine the role of the caregiver in modified Constraint Induced Movement Therapy in a patient with sub-acute stroke Methodology: The study was conducted at the patient's home in Uasin-Gishu County, Kenya. A 52-year-old woman, with a medical history of hypertension, and presented with left-sided hemiplegia. The unaffected hand was constrained in a mitten during working hours, except for bathing and toileting. For 6 weeks, patient spent 4.30 hours performing supervised tasks with paretic arm. Wolf Motor Function Test and the Motor Activity Log were used for data collection. Result: All except two tasks of the timed component of the WMFT had scores above the Minimal Detectable Change; however, the patient could not complete 2 tasks. The Factional Ability Scale and MAL indicated improvement. Conclusion: Support from caregiver increased therapy time, and was a significant factors in improved upper-limb functions.