Efficacy of Constraint-Induced Movement Therapy for Children With Cerebral Palsy With Asymmetric Motor Impairment

Abstract

Pediatric CI therapy produced major and sustained improvement in motoric function in the young children with hemiparesis in the study.

Effects of constraint-induced movement therapy as a rehabilitation strategy for the affected upper limb of children with hemiparesis: systematic review of the literature

“…The results described by Taub et al 16 showed significant improvements in the quality and amount of use of the more impaired limb, compared with previous studies 20,21 . These improvements were explained by the combination of casting with intensive training of contralateral limb using functional activities.…”

“…There was considerable variation between instruments used and between the methods used to evaluate the outcomes presented. The instruments most used were the Emerging Behaviors Scale (two studies 16,17 ), Pediatric Motor Activity Log (two studies 16,17 ) and Jebsen-Taylor Test of Hand Function (two studies 15,18 ).…”

“…The other studies analyzed [15][16][17][18] , unlike the method of Willis et al 19 , prioritized combined interventions that allowed lower intensity of restraint use (in terms of consecutive hours or days). In a study using CIMT for six hours a day over a 10-day period, Charles et al 18 , found considerable evidence of benefits from the use of CIMT, considering effect sizes and changes that were retained for up to six months after the intervention.…”

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“…Rehabilitation of the upper limbs has been associated with fine motor tasks, exercises performed in a unilaterally way, and coordination exercises using both arms (Damiano, 2006;Diez-Alegre et al, 2012;Howcroft et al, 2012;Huber et al, 2010;Hutzler, Lamela-Rodríguez, Laiz-Mendoza, Díez, & Barak, 2013). These tasks have been proven effective in the treatment of CP and other central nervous system disorders such as hemiplegias (Dean and Shepherd, 1997;Taub, Ramey, DeLuca & Echols, 2004). On the other hand, lower limb rehabilitation generally consists on gross motor activities involving repetitive and coordinated movements with both limbs (walking, cycling, etc.…”

Therapeutic approaches and advances in pediatric stroke

“…An RCT has demonstrated the effectiveness of constraint-induced therapy in children with congenital hemiplegia. 132 Other strategies including inhibitive casting, lycra splinting, treadmill training, and functional electrical stimulation remain to be studied in pediatric stroke. The UK guidelines recommend muscle strengthening to improve function and minimize contractures, Botox injections for spasticity, and ankle-foot orthoses for gait and contracture prevention.…”