Efficacy of Constraint-Induced Movement Therapy

January 23, 2018 | Author: Anonymous | Category: Science, Health Science, Neurology
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EFFICACY OF CONSTRAINT-INDUCED MOVEMENT THERAPY INTERVENTION FOR CHILDREN WITH CEREBRAL PALSY Andria Vetsch Mentor: Dr. Jane Case-Smith The Ohio State University, Occupational Therapy Division and University of Wisconsin-River Falls

Introduction  Cerebral

Palsy(CP)  Spastic Hemiplegic CP  Constraint-Induced Movement Therapy(CIMT) 4,5  Features of CIMT    

Constraint of the non-affected limb Forced use of the involved upper extremity Intensive treatment Education of parents

Past Research 

Improved hand-movement efficiency2 

Hands to midline



forearm supination and pronation



transferring a cube between hands



ulnar/palmer grasping with the hands

Investigated the protocol (length, frequency of treatment, populations participating) 1,3,5  Lack of research on fidelity of treatment 

Purpose 1) Assess the consistency in which therapists administer CIMT in a pediatric hospital outpatient setting. 2) Assess inter-rater reliability of the fidelity measure used to score these consistencies. 3) Evaluate the effects of CIMT on a cohort of children with hemiparetic CP

Methods CIMT participants from NCH

Fidelity measure participants

10 children

4 children

Age range: 10 months- 13years

Age range: 21months-10years

Mean age: 3 years

Mean age: 5 years

6 females, 4 males

3 females, 1 male

Affected limbs: 6 right, 4 left

Affected limb: 4 right

Pre-Post assessment scores were collected at Nationwide Children’s Hospital (NCH)

Video recordings were taken throughout treatment session and scored by three raters

Mean scores

Mean Score for Pre-Post Test

Rater 1 2 3

Mean Fidelity Rating Mean rating for Mean rating for Therapist child 2.43 2.07 2.14

2.00 2.25 1.69

Conclusion  





Pre-Post test scores improved Consistency can lead to improved efficacy of therapy Promote the development of new skills and help to generalize skills in a variety of settings Developing a fidelity measure for CIMT and tracking child outcomes

Further Research Continue to assess the administration of CIMT  Continue to research the effects of CIMT 

Questions? 

Thanks to SROP at Ohio State, Dr. Jane Case-Smith, and the University of Wisconsin River-Falls McNair Program for the opportunity to participate in this unique research project.

References 1. Case-Smith, J., and O’Brien,JC. Occupational Therapy for Children. 6th ed. Maryland Heights, MO: Mosby/Elsevier, (2010) Print.

2. DeLuca, Stephanie C., Karen Echols, Charles R. Law, and Sharon L. Ramey. "Intensive Pediatric Constraint-Induced Therapy for Children With Cerebral Palsy: Randomized, Controlled, Crossover Trial." Journal of Child Neurology 21.11 (2006): 931-38. Print. 3. Deluca,SC,Echols,K,Ramey,SL, Taub,E. Pediatric constraint-induced movement therapy for a young child: tow episodes of care. Phy Ther. (2003): 1003-1013Print. 4. Gordon,Andrew M., Charles,Jeanne, Wolf, Steven L. "Methods of Constriant-Induced Therapy for Children with Hemiplegic Cerebral Palsy: Development of a Child-Friendly Intervention for Improving Upper-Extremity Function." Phys. Med. Rehabilitaion 86(2005): 837-44. Print. 5.

Taub, Edward, Sharon Landesman Ramey, Stephanie DeLuca, and Karen Echols. "Efficacy of Constraint-Induced Movement Therapy for Children with Cerebral Palsy with Asymmetric Motor Impairment." Pediatrics 113.2 (2004): 305-12. Print.

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