Kali Decker Reflection – Teaching Key Concepts of Constraint Induced Movement Therapy in Uganda

Kali Decker is a physical therapy resident at MUSC. She was awarded a Center for Global Health Student & Trainee Travel Grant in the spring of 2023 to pursue a project with OneWorld Health in Masindi, Uganda. View more photos of Kali's time in Uganda in this Flickr photo gallery.

Thank you to the Medical University of South Carolina Center for Global Health for granting me the opportunity as a physical therapist resident to travel to Masinidi, Uganda, to implement a pediatric service project. When I was in high school, I was blessed with an opportunity to serve on an international mission trip through my church. That experience started my love for international missions and serving developing countries. However, when I returned home, I realized that although it was a service of love, the work we had completed was not sustainable. When I arrived at MUSC for residency and was informed on the opportunities for service through MUSC and OneWorld Health, I was so excited. It was a dream come true that two of my greatest passions, international missions and pediatric physical therapy, could be joined together to provide underserved communities care that endures.

In 2022, OneWorld Health hired an occupational therapist, David, to implement rehabilitation services at the Masindi Kitara Medical Center. Since then, David has been receiving mentoring from licensed therapist here at MUSC. One patient population that was presenting to the rehabilitation department commonly were children and adults with hemiplegia secondary to stroke. Prior to implementation of my service project, David had been treating these patients one time per month with little improvements in their functional ability. The goal of my project was to expand evidence-based practice through teaching David the key concepts of Modified Constraint Induced Movement Therapy (CIMT) with the hopes of improving functional outcomes for adults and children with hemiplegia for years to come.

We began planning for the trip and project months before our plane ever left Charleston. When the time finally arrived to head to Uganda, I felt so many emotions, but excitement and nervousness were the top two! After 24 hours of travel, we finally arrived in Masindi and hit the ground running. I spent day 1 meeting David, touring the Masindi Kitara Medical Center, and setting up our treatment space. David and I were able to review CIMT and discuss our goals/plan for the week.

On day 2 I met and evaluated the two patients that David and I would be treating for the week, along with their families. From our first encounters it was obvious it was going to be a fun and rewarding week! Day 3-5 were spent training David and providing 2 hours of CIMT to both pediatric patients. Our treatment session was full of fun games and sensory play with a focus on improving use and quality of movement of the hemiparetic side. It was so fun to see the progress each child made following our interventions. By the end of the week, both children demonstrated improvements in functional use of their affected arm and David reported feeling confident in treating future patients with hemiplegia.

I’m very thankful for the opportunity to serve in Masindi with an amazing team from MUSC. I highly recommend this experience to anyone who is interested. I was forced to step out of my comfort zone, and feel I grew tremendously, both personally and professionally. I hope to be a part of future outreach projects for years to come.