Introduction: Modified constraint-induced movement therapy (mCIMT) has a good level of evidence for upper limb (UL) recovery. However, there is limited information on the strategies used to ensure adequate adherence to the protocol at home; Detailed guidelines with activities and resources are needed to increase adherence and ensure safe and effective implementation.
Objective: To evaluate adherence to a protocol of mTMIR combined with transcranial direct current stimulation (tDCS), which includes detailed home guidance.
Methods: In an ongoing randomized clinical trial, where 36 patients received 20 or 30 minutes of tDCS combined with mCIMT, A multicomponent guide with home strategies was generated, including: descriptions of activities and videos, number of hours of restriction, provision of therapeutic materials (sensory and motor), a restraint glove, initial patient and caregiver education, and twice-weekly telephone monitoring. Adherence to glove use and assigned activities was assessed.
Results: 19 patients have entered the clinical trial, with 102 telephone follow-ups to date. 83% reported using the glove at home, averaging 95 minutes per day. 95% percent completed the assigned activity protocol. 5 patients reported pain during activities, most frequently in the shoulder and associated with a prior musculoskeletal conditions. No difficulties with application have been reported.
Conclusion: providing a multicomponent home care guide that includes therapeutic materials, written instructions, and audiovisual support has led to a excellent level of adherence to glove use and the performance of assigned activities, making its use feasible and beneficial for occupational therapists who use mCIMT protocols in their clinical practice.