Continuing professional development is the process by which health professionals keep updated to meet the needs of patients, the health service, and their own professional development. It includes the continuous acquisition of new knowledge, skills, and attitudes to enable competent practice. There is no sharp division between continuing medical education and continuing professional development, as during the past decade continuing medical education has come to include managerial, social, and personal skills, topics beyond the traditional clinical medical subjects. The term continuing professional development acknowledges not only the wide ranging competences needed to practise high quality medicine but also the multidisciplinary context of patient care.
A growing body of research, including evidence from numerous randomized controlled trials, suggests that constraint-induced movement therapy (CIMT) reduces impairment. The mean age of participants in most studies has been <65 yr, even though most stroke survivors are older than that. We investigated the efficacy of a modified CIMT protocol on participation, activity, and impairment in a population of older adults experiencing subacute stroke. Using an interrupted time series design, 4 older adults (mean age 5 82) were assessed before and after intervention. Although none of the participants adhered to the 6-hr per day self-practice aspect of the CIMT protocol, considerable improvements were noted in participation, as measured using the Canadian Occupational Performance Measure. Some improvements were also noted at the level of impairment and activity. This work accords with previous literature on CIMT and has important implications for the evolution of stroke rehabilitation in elderly people.
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