Abstract
Gordon AM, Charles J, Wolf SL. Methods of constraint-induced movement therapy for
children with hemiplegic cerebral palsy: development of a child-friendly intervention
for improving upper-extremity function. Arch Phys Med Rehabil 2005;86:837-44.
We delineate the methodology for constraint-induced movement therapy (CIMT) modified
for children with hemiplegic cerebral palsy (CP) and describe important considerations
that need to be made when testing this intervention in children. The resulting intervention
evolved from piloting and testing it with 38 children with hemiplegic CP who were
between the ages of 4 and 14 years. Thirty-seven successfully completed the treatment
protocol. The intervention retains the 2 major elements of the adult CIMT (repetitive
practice, shaping) and was constructed to be as child-friendly as possible. It involves
restraining the noninvolved extremity with a sling and having the child engage in
unimanual activities with the involved extremity 6 hours a day for 10 days (60h).
Specific activities are selected by considering joint movements with pronounced deficits
and improvement of which interventionists believe have greatest potential. The activities
are chosen to elicit repetitive practice and shaping. The intervention is conducted
in groups of 2 to 3 children to provide social interaction, modeling, and encouragement.
Each child is assigned to an interventionist to maintain at least a 1:1 ratio. CIMT
can be modified to be child-friendly while maintaining all practice elements of the
adult CIMT. The modified therapy is tolerated by most children. Further modifications
will likely be required to hone in on the specific components of the intervention
that are most effective before applying them to children who are most likely to benefit.
Key words
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Article info
Footnotes
Supported by the National Center for Medical Rehabilitation Research, National Institute of Child Health and Human Development (grant no. HD 40961).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
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Copyright
© 2005 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
