Early childhood constraint therapy for sensory/motor impairment in cerebral palsy: a randomised clinical trial protocol

Abstract

IntroductionCerebral palsy (CP) is the most common physical disability in childhood. It is a disorder resulting from sensory and motor impairments due to perinatal brain injury, with lifetime consequences that range from poor adaptive and social function to communication and emotional disturbances. Infants with CP have a fundamental disadvantage in recovering motor function: they do not receive accurate sensory feedback from their movements, leading to developmental disregard. Constraint-induced movement therapy (CIMT) is one of the few effective neurorehabilitative strategies shown to improve upper extremity motor function in adults and older children with CP, potentially overcoming developmental disregard.Methods and analysisThis study is a randomised controlled trial of children 12–24 months corrected age studying the effectiveness of CIMT combined with motor and sensory-motor interventions. The study population will comprise 72 children with CP and 144 typically developing children for a total of N=216 children. All children with CP, regardless of group allocation will continue with their standard of care occupational and physical therapy throughout the study. The research material collected will be in the form of data from high-density array event-related potential scan, standardised assessment scores and motion analysis scores.Ethics and disseminationThe study protocol was approved by the Institutional Review Board. The findings of the trial will be disseminated through peer-reviewed journals and scientific conferences.Trial registration numberNCT02567630.

Management of Stroke in Neonates and Children: A Scientific Statement From the American Heart Association/American Stroke Association

“…An ongoing clinical trial is evaluating its efficacy. 321 Constraint therapy has been associated with improved function of the hemiparetic hand. 322 Improvements are sustained over a prolonged period of time, and late deterioration is rare.…”

Implementation of Early Diagnosis and Intervention Guidelines for Cerebral Palsy in a High-Risk Infant Follow-Up Clinic

“…Research was integrated through additional workspace, training of coordinators, improved communication with nursing and social work leaders, and visibility of rehabilitation study materials. 22,23 Parent support was addressed through counseling with the elements recommended in published literature and the guideline mandates: "face-to-face, with both caregivers present if appropriate, private, honest, jargon-free, with empathic communication tailored to the family." 4 Identification of strengths and goals was included, and questions were fostered by allowing the diagnosing provider to return at conclusion of the visit to reassess the emotional context and answer additional questions.…”

Constraint induced movement therapy for children with spastic hemiparesis cerebral palsy and mental disorder: report of a case study

“…However, the shaping can be considered a strategy to change this condition. Chorna et al (2015) reported that shaping of movement through guide repetition during CIMT creates experience of successful movement essential to inferring more efficient actions and with that reverse the "learned non-use" of the affected upper limb in everyday situations and social involvement [12]. In the systematic review about CIMT in children with SHCP without Mental Disorders, the authors found that CIMT had a beneficial effect and furthermore, this effect was beneficial in terms of both activity and participation, suggesting that the improved upper limb activity carried over into what the children actually did in real life with their upper limb [4].…”