Constraint Induced Movement Therapy
Constraint Induced Movement Therapy (CIMT) is being explored as a therapy option for improving upper limb function in children with cerebral palsy.
Limited hand function can become a major disability for children with hemiplegic CP. Children prefer to perform daily tasks with their unaffected hand as it is more efficient and effective.
As a result, many children often fail to learn to use their affected hand to its full potential, preferring to rely on their unaffected arm to perform daily tasks. CIMT is one therapy technique aimed at increasing function.
In early 2007 Margaret Wallen, Senior Research Occupational Therapist at the Children’s Hospital at Westmead, was awarded the CP Foundation’s first academic grant to assist her PhD studies on the effectiveness of CIMT for children with CP.
Margaret’s randomised controlled trial of children aged from 18 months to 8 years with hemiplegic CP explored whether wearing a mitt (constraint) on the unaffected hand for daily therapy (movement therapy) would facilitate these children to use their affected hand more proficiently, compared with standard best practice occupational therapy options- including stretching, peripheral splinting and casting, motor learning and neuro-developmental therapy.
Over the course of eight weeks, Margaret and her team will work closely with families to ensure that the CIMT is directed at developing particular patterns of movement.
These movement patterns are those that the child needs to accomplish in order to more effectively complete everyday activities, such as dressing and eating, which the family and child select as intervention goals.
Two-hour daily programs incorporated into play and functional activities will be developed to teach the child’s movement patterns required for daily tasks.
To ensure the child is correctly using their affected hand at home and to upgrade therapy as improvement occurs, weekly visits to the OT will be required. The results from each of the 50 children in the study will then be evaluated by independent evaluators who are unaware of the type of therapy received by each child.
This study will help answer the question of which therapy is most effective for hemiplegic children aged between 18 months and 8 years.