Constraint-Induced Movement Therapy in Obstetrical Brachial Plexus Palsy: A Single-Blind Pilot Randomized Controlled...

Area of Science:

• Pediatric Rehabilitation
• Neurology
• Physical Therapy

Background:

• Obstetrical Brachial Plexus Palsy (OBPP) can impair upper limb function in children.
• Conventional therapies aim to improve motor skills but may have limitations.

Purpose of the Study:

• To compare the effectiveness of Constraint-Induced Movement Therapy (CIMT) against conventional therapy for children with OBPP.
• To assess improvements in arm usage frequency, quality, spontaneity, and new motor program acquisition.

Main Methods:

• A pilot randomized controlled trial was conducted with 20 children diagnosed with OBPP.
• Participants were assigned to either CIMT (intensive, 5x/week) or conventional therapy (2x/week).
• Evaluations included the Pediatric Mal Activity Log - Revised (PMAL-R), Pediatric Arm Function Test (PAFT), and Inventory of New Motor Activities and Programs (INMAP) pre- and post-treatment.

Main Results:

• CIMT showed significant superiority over the control group in improving movement frequency (p < 0.001) and quality (p < 0.001).
• Enhanced spontaneity of use in unimanual tasks was observed with CIMT (PAFT: p = 0.022).
• Significant gains in acquiring new motor programs were noted with CIMT (INMAP: p < 0.001), with large effect sizes.

Conclusions:

• Constraint-Induced Movement Therapy (CIMT) is more effective than standard care for children with OBPP.
• CIMT leads to substantial improvements in motor function, including movement quality, frequency, and the acquisition of new motor skills.
• The findings support CIMT as a preferred therapeutic approach for improving upper limb function in OBPP.