FREQUENTLY ASKED QUESTIONS

Let’s look at Joe, a patient who had a stroke and is unable to use his right arm and hand. Joe begins therapy in the hospital where his hand is stretched and he’s taught tone management. He learns to use his strong left hand to take over for his impaired right hand. He is then released from therapy. At this point Joe becomes a CIMT candidate. CIMT will focus on teaching Joe to use his right hand. CIMT uses the principles of constraint, forced use, and massed practice to overcome “learned non-use”. CIMT uses the brain’s neuroplasticity phenomenon to “rewire” connections to Joe’s right arm and hand. Through intense practice focused on specific goals, CIMT can result in functional improvements even after a plateau has occurred in traditional therapy. Traditional therapy is not set up to treat one client for several hours a day whereas our program devotes the number of hours needed to get results.

Prior to studies on CIMT, health professionals were taught that progress can only be made in the first year or so after a stroke or brain injury. Research on CIMT has shown that this is not true because the brain can be stimulated to reorganize and “communicate” with the affected arm and hand. Our program is designed to stimulate the brain to reorganize by working more intensely than you ever have before. We’ve personally seen clients make progress more than 12 years after their stroke or brain injury.

If your hand is weak and/or has a moderate amount of spasticity (increased muscle contraction/tone) then the Saebo can be a useful tool to begin training movement. The SaeboFlex orthosis may be needed to assist with opening and closing of your fingers during the CIMT therapy. Saebo therapy is performed by a  Saebo trained therapist and it’s used in conjunction with CIMT. If your fingers are clenched into a fist and can be passively stretched open, then the SaeboStretch can be worn for several hours a day to stretch the fingers prior to beginning CIMT. This stretching phase may take a few weeks to several months. The SaeboFlex or SaeboStretch require a separate therapy evaluation for measurements and ordering directly from Saebo. Insurance will usually pay a portion of the cost for the Saebo orthosis.

Most people are or can become a candidate. If you aren’t a candidate for CIMT, you may be a candidate for the SaeboFlex. For the SaeboFlex, you should have some shoulder and elbow movement in any direction and be able to passively stretch your fingers so that your hand is open. For CIMT, you need some shoulder and elbow movement and be able to actively straighten your wrist and fingers. Our therapist will evaluate you to determine if you’re a candidate and will recommend a therapy plan to fit your needs.

Adults, adolescents, and children. Research has shown that movement can be improved in all ranges.

Many clients are able to see a small change at the end of their first day. Subsequent days continue to build upon these early successes. The program is designed to “jump start” your movement to a new level and continue to move forward. We expect you’ll see improvement during your course of therapy and your progress can continue by doing the specific home exercises we’ll teach you. As long as you are challenging yourself and work every day, you have the potential to keep improving.

We encourage a balance of caregiver and client participation. There may be times when we will want your caregiver to participate and other times when we will need your full attention and effort on the task. We devote time at the beginning and end of each session to answer questions, assign homework, discuss progress, etc. There will be ample personal time for your caregiver to spend time alone and catch up on daily responsibilities.

Yes. A prescription is required for the therapist to treat you and it’s always a good idea to keep your doctor informed. We’ll help you obtain a prescription from your primary physician.

Your home environment provides the ideal setting for our program. Your home is familiar and comfortable to you, offers “real life” challenges, and eliminates the physical and mental stress of traveling to a clinic. For California residents, our therapist travels to your location in California and will stay nearby for the duration of your program. Many out of state clients will travel to California to stay with family/friends and the therapist will travel to your location. Other out of state clients arrange accommodations near Pasadena, CA and our therapist will provide treatment locally.

The majority of clients private pay for our services. We are a Medicare participating provider and Medicare may cover a portion of your cost if you reside in California. For other insurance coverage, you should call your specific insurance carrier and ask about out of network coverage for outpatient physical therapy in your home. Therapy is provided by a licensed physical therapist. We don’t bill non-Medicare insurances, but will provide any information you or your insurance company needs for submitting a claim.

The fees are the same for both programs, except for a separate evaluation fee for the Saebo orthosis that covers measuring your arm and hand and ordering the device from Saebo. CIMT and Saebo training is a long term investment for achieving maximum recovery. Our fees include the therapy as well as a home program, quarterly progress discussions, and follow up care such as consults by phone or email. We offer several types of programs and discounts which can fit your budget. Therapy programs can be hourly or 4-6 hours per day for 10 to 15 consecutive days. Program fees range from $175 per hour for our Pay as You Go plan to several thousand for our Signature program. We have substantial program discounts for returning clients. Custom programs are available. Please contact us to discuss an option that fits your needs and to request a fee schedule.