Constraint-Induced Movement Therapy for Infants With or at Risk for Cerebral Palsy: A Scoping Review
Monik Castillo Dionisio1, Alexandra L Terrill2
1Monik Castillo Dionisio, MS, OTR/L, BCP, CPAM, is Occupational Therapist, California Children's Services, Anaheim, and Post-Professional Doctoral Student, Department of Occupational and Recreational Therapies, University of Utah, Salt Lake City; monik.dionisio@gmail.com.
Insights
Constraint-Induced Movement Therapy (CIMT) shows promise for infants with cerebral palsy (CP). This review summarizes existing evidence, highlighting the need for standardized protocols and further research to confirm efficacy in this population.
Area of Science:
- Pediatric Rehabilitation
- Neurology
- Occupational Therapy
Background:
- Older children with hemiplegic cerebral palsy (CP) benefit from constraint-induced movement therapy (CIMT).
- The efficacy of CIMT in infants with CP is not well-established.
- This study focuses on infants aged 24 months and younger with CP or at risk for CP.
Purpose of the Study:
- To conduct a scoping review of existing evidence on CIMT for infants with CP.
- To explore CIMT protocols, including dosage, constraint, administration, and parent training.
- To identify gaps in research regarding CIMT for infants.
Main Methods:
- Searched major databases (PubMed, CINAHL, Cochrane, ProQuest) for relevant studies published between 2000 and 2020.
- Included studies on infants with hemiplegic CP, focusing on upper limb function changes.
- Utilized PRISMA and AOTA guidelines for data abstraction and quality assessment.
Main Results:
- Eight articles met the inclusion criteria, including RCTs, cohort, pretest-posttest, single-subject, and case studies.
- Examined variability in CIMT protocols regarding dosage, constraint, administration, and outcome measures.
- Found existing literature supports CIMT protocols but notes significant variability.
Conclusions:
- Current literature supports CIMT protocols for infants with CP.
- Variability in protocol design and outcome measures necessitates further research.
- Higher-level research is needed to establish the efficacy and practice standards for CIMT in infants.
Importance:
Although research shows that older children with hemiplegic cerebral palsy (CP) benefit from constraint-induced movement therapy (CIMT), the efficacy of CIMT among the infant population is unknown.
Objective:
To explore the existing evidence on CIMT for infants age 24 mo and younger with CP or at risk for CP.
Data Sources:
PubMed, CINAHL, Cochrane, and ProQuest were searched. Study Selection and Data Collection: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and American Occupational Therapy Association guidelines were used for abstracting data and assessing data quality. Two frameworks guided this scoping review. Studies met the following criteria: infants with hemiplegic CP, published in English between 2000 and 2020, peer reviewed, and addressed changes in upper limb function of the hemiplegic upper limb.
Findings:
Eight articles met the inclusion criteria: 2 randomized controlled trials, 1 retrospective cohort design, 1 pretest-posttest study, 2 single-subject studies, and 2 case studies. In this scoping review, we examined CIMT protocols for an overview of dosage, constraint, administration, parent training and education, and objective outcome measures.
Conclusions And Relevance:
Existing literature supports CIMT protocols for infants with CP. However, much variability exists in protocol design and appropriate outcome measures among studies. Higher level research is needed to support the efficacy of CIMT among infants with CP. What This Article Adds: This scoping review summarizes the existing literature on CIMT for infants with hemiplegic CP. This information can help guide therapists to implement CIMT protocols in the clinical setting and to identify additional research to establish practice standards.
