Upper limb function improves with constraint-induced movement therapy, reports APTA

A recent study of 894 children ranging from 2 to 11 years of age who have Cerebral Palsy supports the use of constraint-induced movement therapy, or CIMT, as an effective short-term intervention for the improvement of upper-limb function. The children participated in a 5-day per week intervention program over a 2 to 3-week period. The same study, though, did caution about the long-term effectiveness of the treatment, suggesting that CIMT could not be maintained over time.

CIMT is a treatment intervention that forces the use of the affected side of the body while restraining the unaffected side. Casts, gloves, mittens and slings are used to restrain the use of unaffected limbs while the child is encouraged to repetitively and intensively use the affected limb.

During the study, a series of 27 random controlled trials were conducted between 2004 and 2014 to compare CIMT to other intervention methods. Participants had medium effect improvements to arm functionality immediately after the therapy and during follow-up, similar to the effect of CIMT treatment results in adults recovering from a stroke. And, children receiving treatment in the home-based settings produced better results than clinic or camp-based environments, according the study published on August 14, 2014 in Clinical Rehabilitation.

“Studies examining constraint-induced movement therapy effect without a dose-equivalent comparison group showed a large effect in children with Cerebral Palsy, but studies with a dose-equivalent group only showed a small effect,” reports the Clinical Rehabilitation abstract summary. The location of intervention and the time of follow-up are significant factors.

Dr. Edward Taub, a University of Alabama psychology professor, developed CIMT to help stroke survivors regain lost functionality in affected limbs. He is encouraged by studies that suggest constraint-induced therapy can improve brain activity.

“This finding offers hope to researchers who believe it may be possible to stimulate or manipulate brain areas to take over lost functions, a process known as cortical reorganization,” said Dr. Taub in an article titled, A Rehab Revolution published in StrokeCONNECTION Magazine’s September/October 2004 edition. The article lists CIMT as one of four therapies showing better results than conventional therapy. The other three therapies are identified as biofeedback, electrical stimulation and partially supported treadmill training. These interventions require forced movement, repetition, and intensity to gain back function, as opposed to traditional therapy that requires slow progressive improvement over time.

For more information:

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To learn about the treatments and therapies commonly prescribed to treat Cerebral Palsy, visit Treatments and Therapies for Cerebral Palsy.

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Chen YP, Pope S, Tyler D, and Warren GL (August 14, 2014). “Effectiveness of constraint-induced movement therapy on upper-extremity function in children with Cerebral Palsy: a systematic review and meta-analysis of randomized controlled trials,” Clinical Rehabilitation.

News Now Staff (August 28, 2014). “CIMT Can Be Effective for Children with Cerebral Palsy,” PT in Motion News, American Physical Therapy Association.

Springer, Emily (September/October 2004). “A Rehab Revolution,” StrokeCONNECTION, page 20.

Website article (September 19, 2014). “Constraint-Induced Movement Therapy May Improve Upper-Limb Function in Cerebral Palsy Patients,” retrieved online from Physical Therapy Products.

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