Introduction
Modified constraint-induced movement therapy (mCIMT) is an effective intervention to improve upper limb function after stroke, yet few stroke survivors receive this therapy. A behaviour change intervention to increase provision of mCIMT within an early-supported discharge (ESD) rehabilitation service identified clinician concerns regarding the acceptability of mCIMT among stroke survivors and carers, consistent with findings published internationally. This study sought to explore the acceptability of mCIMT among stroke survivors and carers within an ESD service and inform further adaptations to the program to enhance acceptability.
Methods
Qualitative study within a mixed methods process evaluation of mCIMT implementation. Semi-structured interviews were analysed using reflexive thematic analysis and mapped to the Capability, Opportunity, Motivation- Behaviour (COM-B) model.
Results
Fifteen stroke survivors and ten carers participated. Five themes were generated and mapped to the COM-B. Participants attributed functional improvements to mCIMT whilst also encountering several challenges with returning home after stroke (Capability- physical); the importance of education (Capability- psychological); the benefits afforded by the structured nature of the program (Opportunity- physical); the challenges for carers to support mCIMT programs whilst navigating new relationship roles (Opportunity- social); the desire to improve (Motivation- automatic); and the influence each of the mCIMT program’s components had in facilitating long-term upper limb use (Motivation- reflective).
Conclusion
mCIMT was an acceptable intervention for stroke survivors and carers within the ESD service, offering considerable benefits compared to other therapies. The findings suggest that multifaceted education strategies could increase stroke survivor preparedness. Extending the mCIMT program duration may maximise functional improvements.
Relevance to clinical practice or patient experience
Structured rehabilitation programs, such as mCIMT, can support the transition home for stroke survivors, providing guidance and hope without additional carer burden. These novel findings challenge established perceptions of mCIMT acceptability among stakeholders, providing critical insights for translating mCIMT into clinical practice.