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The effect of modified constraint-induced movement therapy in children with hemiparetic cerebral palsy. Consecutive
1Department of Physical Therapy and Rehabilitation, Bolu Abant Izzet Baysal University, Bolu, Turkey.
Insights
Modified constraint-induced movement therapy (mCIMT) improved upper limb function in children with hemiparetic cerebral palsy. Intermittent mCIMT was found to be more tolerable and potentially more effective for pediatric patients.
Area of Science:
- Pediatric Rehabilitation
- Neurology
- Occupational Therapy
Background:
- Hemiparetic cerebral palsy (CP) significantly impacts upper limb function in children.
- Constraint-induced movement therapy (CIMT) is a common intervention, but modified approaches (mCIMT) are being explored.
- Optimizing mCIMT administration schedules is crucial for maximizing therapeutic benefits in pediatric populations.
Purpose of the Study:
- To compare the effects of consecutive versus intermittent modified constraint-induced movement therapy (mCIMT) on upper limb function in children with hemiparetic cerebral palsy (CP).
- To evaluate the efficacy of different mCIMT schedules on daily life activities, speed, grasping efficiency, and comfort.
Main Methods:
- A study involving 33 children (5-18 years) with hemiparetic CP, divided into consecutive mCIMT, intermittent mCIMT, and control groups.
- Utilized outcome measures including GMFCS, MACS, PBS, MTS, JTHFT, CHEQ, Abilhand Kids, and sEMG.
- Evaluations were conducted at baseline, 10 days, and 5 weeks post-intervention.
Main Results:
- Both mCIMT groups showed significant improvements in upper extremity use, activity speed, grasping efficiency, and reduced discomfort compared to the control group.
- Improvements in daily living activities, speed, and grasping efficiency were statistically significant (p < 0.01).
- The magnitude of improvement between the consecutive and intermittent mCIMT groups was not statistically different (p > 0.05).
Conclusions:
- Modified constraint-induced movement therapy (mCIMT) is more effective than conventional therapies for improving upper limb function in hemiparetic CP.
- Administering mCIMT on intermittent days may enhance child adaptation, tolerability, and participation.
- Integrating mCIMT within the child's natural environment can boost motivation and treatment adherence.
Purpose:
To investigate effect of modified constraint-induced movement therapy (mCIMT) administered on consecutive or intermittent days on upper limb function in children with hemiparetic cerebral palsy (CP).
Materials And Methods:
Thirty-three children (age range 5-18 y) with hemiparetic CP separated into three groups: consecutive mCIMT group (n = 11), intermittent mCIMT group (n = 11), control group (n = 11). The outcome measures consist of Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), Pediatric Balance Scale (PBS), Modified Tardieu Scale (MTS), Jebsen-Taylor Hand Function Test (JTHFT), Children's Hand Use Experience Questionnaire (CHEQ), Abilhand Kids Questionnaire, surface Electromyography (sEMG). The evaluations were made baseline, 10 days after, 5 weeks after the treatment.
Results:
Improvements were achieved in all groups. The use of upper extremities in daily life activities (p < 0.01), speed of performing the activities (p < 0.001), grasping efficiency (p < 0.001), the amount of a decrease in the children's sense of discomfort while performing activities (p < 0.001) on the affected side in both mCIMT groups were better than the control group. The gain levels in mCIMT groups were similar (p > 0.05).
Conclusions:
Administration of mCIMT on intermittent days facilitate the adaptation of a child, it was concluded to be a more tolerable method and could be more effective.Implications for rehabilitationmCIMT is more effective than low-dose conventional therapeutic interventions in improving paretic upper limb functions in children with hemiparetic CP.The application of mCIMT in the child's natural environment increases the motivation to participate in the treatment.The application of mCIMT on intermittent days will be more easily tolerated in paediatric individuals and will increase participation in the treatment.
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