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Efficacy of modified constraint induced movement therapy in improving upper limb function in children with hemiplegic
Anita Choudhary1, Sheffali Gulati, Madhulika Kabra
1Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India.
Insights
Modified constraint induced movement therapy (mCIMT) significantly improved upper limb function in children with hemiplegic cerebral palsy. These gains were sustained 8 weeks after therapy completion.
Area of Science:
- Pediatric Rehabilitation
- Neurology
- Physical Therapy
Background:
- Cerebral palsy (CP) is a common neurodevelopmental disorder.
- Hemiplegic CP affects one side of the body, impacting upper limb function.
- Early intervention is crucial for functional improvement in children with CP.
Purpose of the Study:
- To evaluate the efficacy of modified constraint induced movement therapy (mCIMT).
- To assess improvements in upper limb function in children aged 3-8 years with hemiplegic cerebral palsy.
- To compare mCIMT combined with conventional therapy versus conventional therapy alone.
Main Methods:
- Randomized single-blind controlled trial.
- 31 children with hemiplegic cerebral palsy were randomized into mCIMT (N=16) or control (N=15) groups.
- Outcome measures included QUEST scores and the nine-hole-pegboard test at baseline, 4 weeks, and 12 weeks.
Main Results:
- The mCIMT group showed significant improvements in QUEST scores (10.7 ± 5.2 vs 1.4 ± 1.7, p<0.001).
- Significant improvements were observed in the nine-hole-pegboard test completion time (p<0.001).
- Functional improvements persisted 8 weeks post-intervention.
Conclusions:
- Modified constraint induced movement therapy (mCIMT) is effective for improving upper limb function.
- mCIMT offers a promising therapeutic approach for young children with hemiplegic cerebral palsy.
- The observed benefits of mCIMT are sustained after therapy cessation.
Purpose:
The objective of this randomized single blind (outcome assessor) controlled trial was to evaluate the efficacy of 4 weeks of modified constraint induced movement therapy (mCIMT) in improving upper limb function in 3-8 years old children with hemiplegic cerebral palsy.
Methods:
Thirty-one children were randomly assigned to receive the mCIMT (N=16) with conventional therapy or conventional therapy alone (N=15). Children were evaluated three times (at enrollment, follow up at 4 weeks and 12 weeks). The primary outcome measure was difference in "change in mean total QUEST scores" at 4 weeks of intervention between the intervention and the control arm.
Results:
After 4 weeks of intervention, mCIMT group showed significant change in the affected upper limb in QUEST scores (10.7 ± 5.2 vs 1.4 ± 1.7, p<0.001) and time (s) to complete nine-hole-pegboard test compared with control group [60(0-130) vs 5(-12 to 30), p<0.001]. The improvement observed in upper limb function after 4 weeks of intervention persisted 8 weeks after discontinuation of intervention in mCIMT group.
Conclusion:
The modified constraint induced movement therapy appears to be effective in improving upper limb function in 3-8 years old hemiplegic cerebral palsy children.
