Effect of therapist-based constraint-induced therapy at home on motor control, motor performance and daily function in children with cerebral palsy: a randomized controlled study

Abstract

Constraint-induced therapy induced better grasping performance, daily function, and temporal and spatiotemporal control of reaching in children with unilateral cerebral palsy than traditional rehabilitation.

Constraint-induced movement therapy of upper limb of children with cerebral palsy in clinical practice: systematic review of the literature

“…CIMT was not employed in its classic form and was modified with respect to the constraint method, duration of constraint (days or weeks), type and duration of therapy, intervention setting (home, school or clinic) and intervention provider (therapist, parent or teacher). The first significant variant was the method employed to constrain the unaffected limb, for which a range of techniques was used, such as a mitt 21,22,[24][25][26]28 , sling [17][18][19][20] , cast 27 and splint…”

“…In some studies, children were encouraged to use the affected limb in functional and avd's activities at home under parental supervision, with no need for restraint of the affected limb 21,22,24 or were submitted to complementary therapy with unimanual and bimanual exercises through games at home 19 . Chen et al 21 employed home-based CIMT, which consisted of the same principles as modified CIMT, but the therapist conducted the training in the child's home.…”

“…For the functional classification of individuals eligible for inclusion in the study, the Manual Abilities Classification System (MACS) was used in two studies 17,18 , which was developed to categorize, respectively, the mobility and manual function of children with CP 31,32 . Other studies included in this review used the results of the Quality of Upper Extremity Skills Test (QUEST), Pediatric Motor Activity Log (PMAL) and Jebsen-Taylor Hand Function Test ( JTHF) as part of the inclusion criteria 19,[22][23][24] . It is recognized that the PMAL evaluation scale is an evaluation tool of little reliability and insufficient validity 33 .…”

“…Cognitive capacity, cooperation and comprehension of the commands were employed as inclusion criteria in the majority of studies, which are essential to conducting studies of this nature and obtaining the expected benefits. According to Moura 34 21,24 , the Peabody Developmental Motor Scales -Second Edition (PDMS-2) was used in two studies 21,22 and the Pediatric Evaluation of Disability Inventory (PEDI) was used by Brandão et al 19 . Other outcome measures were employed in the remaining studies.…”

“…In 9 of the 12 clinical trials [17][18][19][20]22,23,[25][26][27] , difficulties and dropouts occurred due to family problems, scheduling problems, changes of address and a lack of transportation. In the study by Sakzewski et al 26 , nine of the participants dropped out of the study groups and a seizure occurred in one child during treatment; however, the authors did not describe the dropouts in detail.…”