TeleCIMT Therapist Program Resources
Welcome to the TeleCIMT therapist resources! The therapist resources include all the clinical forms required to conduct a TeleCIMT program, from screening through to program completion. TeleCIMT forms can be filled out electronically or manually for your clinical notes. Please complete the recommended therapist learning prior to using the forms in clinical practice.
Please note: The TIDE Group has developed all the clinical paperwork required to guide delivery of a TeleCIMT program in practice. The clinical resources are intended solely for: Qualified physiotherapists and occupational therapists with experience in neurological rehabilitation; and Therapy assistants and students under the direction of a qualified therapist.
Full program resources
- TeleCIMT delivery checklist - A step-by-step guide to conducting a TeleCIMT program. It includes all phases of TeleCIMT and each step can be ticked off, dated and initialled, to help you keep track.
- Therapist timetable guideline
- TeleCIMT therapist resource pack - All clinical forms, in order, in one document.
Resources are formatted with Word and therefore may not appear correctly on your mobile device. Documents may be edited if authorship is acknowledged; the documents can be unlocked - in Word, search for "Restrict Editing", stop protection with password "TeleCIMT2020"
Resources per phase
While the TeleCIMT therapist resource pack (above) include all clinical forms, you can browse TeleCIMT phases below to find specific ones. Some sections have additional resources provided to help you work through the TeleCIMT process.
Screening
You can use the TeleCIMT screening form to help decide whether someone is suitable for TeleCIMT or not. For therapists wanting more information on the screening process, please read the below ‘Additional information on TeleCIMT screening’ sheet. Patients going through the TeleCIMT screening process can be provided with one of the ‘TeleCIMT information brochures’ below.
Assessment
Prior to the TeleCIMT assessment, provide the participant / supporter with the ‘TeleCIMT preparation pack’, allowing enough time for them to work through it. Where possible, participants being assessed for their TeleCIMT program over video call can send you short videos of themselves attempting four specific functional tasks prior to assessment session (see the ‘TeleCIMT assessment’ form below for details). They can read their preparation pack and watch the related video to find out how to do this.
Tip: Getting the participant to send you a video of their home and outdoor environment can be useful to help set up shaping and task practice items.
Additional Resources & Outcome Measures
Motor Activity Log (MAL)
Motor Activity Log (MAL) is a subjective measure of an individual’s real life functional upper limb performance. The MAL is administered by semi-structured interview to determine (a) how much, and (b) how well the individual uses his/her upper limb in his/her own home. (MAL developed by: Edward Taub, Karen McCulloch, Gitendra Uswatte, & David M. Morris.)
- MAL measure
- MAL flowchart - AROT clinical paperwork for home-based CIMT (Boydell, 2018)
- Video: how to administer the MAL - Thanks to ACTIveARM Project (Christie, L. et al 2017)
Program Preparation
After assessment, you will need to complete a preparation session with your participant and their supporter. Use the forms below to agree on important elements of the program during this session:
- Mitt on and mitt off activities
- Tasks I want to practice
- Keeping safe: your mitt removal list
- TeleCIMT schedule
- Useful items to increase weaker arm use
The forms are therapist copies of worksheets from the participant’s ‘Preparation pack’. This means you can both use the same paperwork when discussing the program over video call. After the session, you can place the forms directly in your clinical notes.
Once the preparation session is completed, fill in the participant ‘Program pack’ and send it to your participant / supporter at least three days prior to the program starting. The pack is tailored to them and includes all the forms they will need to complete the program.
Use the ‘Shaping practice’ and 'Task practice’ libraries (in the 'Intervention' section below) when planning suitable tasks for participants to complete during structured training hours.
You may wish to send a copy of the ‘Useful TeleCIMT items list’ above to some participants to assist their program.
Intervention
When setting up TeleCIMT intervention on the first day of the program, ensure the participant / supporter have understood the function of all forms in their ‘Program pack’. During the three-week program, use the ‘TeleCIMT therapist review’ form below to regularly monitor your participant’s progress. For more ideas on practice tasks during structured training hours use the ‘Shaping practice’ and ‘Task practice’ libraries below. If you provide additional homework to your participant, they can use the ‘Homework sheet’ below to record daily tasks on.
Evaluation & Post-Program Planning
Below are therapist forms for evaluating the effectiveness of the TeleCIMT program, setting further goals and agreeing on a CIMT practice plan for after the program. You can use the ‘TeleCIMT feedback questionnaire’ with participants to further inform your service.
A thorough re-assessment of the outcome measures assessed initially is also important at the conclusion of the program.
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