Oral Presentation Smart Strokes Annual Scientific Meeting 2025

A feasibility study of remote constraint induced therapy of the upper extremity (ReCITE) (127199)

Lauren J Christie 1 2 3 , Nicola Fearn 4 , Annie Mccluskey 5 , Natasha A Lannin 6 7 , Christine Shiner 8 9 , Anna Kilkenny 10 11 , Jessamy Boydell 12 , Annie Meharg 13 , Leonid Churilov 14 , Laura Jolliffe 15 16 , Kate Makroglou 1 2 , Steven Faux 9 17 , Sandy Middleton 3
  1. Allied Health Research Unit, St Vincent's Health Network Sydney, Darlinghurst, NSW, Australia
  2. Faculty of Health Science, Australian Catholic University, Sydney, NSW, Australia
  3. Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne and Australian Catholic University, Darlinghurst, NSW, Australia
  4. The University of Sydney, Camperdown, NSW, Australia
  5. The StrokeEd Collaboration, Ashfield, NSW, Australia
  6. Department of Neuroscience, Monash Univeristy, Melbourne, Victoria, Australia
  7. Alfred Health, Melbourne, Victoria, Australia
  8. Health Equity Research, St Vincent's Health Australia, Sydney, NSW, Australia
  9. School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
  10. Centre for Health and Social Pratice, Wintec, New Zealand
  11. Align Health, Cambridge, New Zealand
  12. Arms Reach OT, Bristol, United Kingdom
  13. Private Practitioner, Bath, United Kingdom
  14. Melbourne Medical School, The University of Melbourne, Parkville, Victoria, Australia
  15. Monash Translational Medicine, Monash Univeristy, Melbourne, Victoria, Australia
  16. Allied Health, Peninsula Health, Frankstown, Victoria, Australia
  17. Department of Rehabilitation, St Vincent's Health Network Sydney, Darlinghurst, NSW, Australia

Introduction: Constraint induced movement therapy (CIMT) is an effective intervention for arm recovery post-stroke. CIMT is primarily delivered face to face, limiting accessibility for stroke survivors and requiring significant therapist time. We aimed to evaluate the feasibility and acceptability of delivering CIMT via telehealth (TeleCIMT) to address these barriers.

Methods: We used a prospective mixed method, single blinded design. Adult stroke survivors with mild to moderate upper limb impairment were recruited from four outpatient clinics and received a 3 week, semi-supervised TeleCIMT program. Therapists provided TeleCIMT within usual care, supported by an implementation package designed using the Behaviour Change Wheel. Programs consisted of at least 2 hours of daily practice, 6 hours of mitt wear and a transfer package. Baseline, post-intervention and one month follow-up outcomes and adverse events were recorded. Acceptability was evaluated through participant interviews. Data were analysed using inferential statistics (quantitative) and thematic analysis (qualitative).

Results: Nineteen participants were recruited; 18 completed post-program measures. Most participants (n=15, 83.3%), completed more than 80% of planned intervention (> 24 hours of practice); all remaining participants (n=3, 16.7%) achieved >20 hours. Participants demonstrated significant improvements on the Action Research Arm Test (MD 6.3, 95%CI 1.3-11.3), Box and Block Test (MD 5 blocks, 95%CI 0.5-8.8) and self-reported amount of use and quality of arm movement (AoU MD 0.8, 95%CI 0.3-1.3; QoM MD 0.7, 95%CI 0.2-1.3; all p<0.05). No significant differences in dexterity, grip strength and quality of life were observed. TeleCIMT was acceptable to stroke survivors. Additional support for technology set up and recording practice were suggested. Access to therapist coaching was essential to maintain motivation. 

Conclusion: TeleCIMT is feasible and acceptable and may address inequities in accessing evidence-based stroke rehabilitation.

Relevance to clinical practice: TeleCIMT has potential to be implemented routinely in practice to overcome barriers to access.