Gait characteristics of children with hemiplegic cerebral palsy before and after modified constraint-induced movement therapy

Abstract

This investigation assessed selected gait parameters of children with hemiparesis before and after participation in a modified constraint-induced movement therapy program (mCIMT). Recent advances in the understanding of the relationship between mCIMT and cortical reorganization supports the use of upper-extremity mCIMT to treat lower extremity deficits. However, the effects of mCIMT on the gait patterns of children with hemiparesis remain unclear. Twelve preschool children participated in a mCIMT program for 5 consecutive days, 6 h each day. Pre- and post-intervention data, on the temporal-spatial aspects of gait, were collected with the GAITRite walkway. Data were analyzed using a repeated measures generalized linear model. Base of support decreased significantly (p < 0.001) following treatment and improvements were noted in most other gait descriptors. The results of this study suggest that mCIMT can increase stability and improve the overall gait pattern. This study provides a new dimension in the effects of pediatric mCIMT programs and could begin to shift the focus of this intervention to remediation of lower extremity deficits. Additional studies with a longitudinal follow-up focus to determine the long-term effects of mCIMT on walking balance and stability would be beneficial.

Keywords:

• Cerebral palsy
• hemiplegia
• constraint therapy
• gait

Acknowledgements

The Medical University of South Carolina, College of Health Professions, Department of Rehabilitation Sciences Pilot Research Grant for Developing Investigators Coastal Community Foundation; Charles Webb-Ed Croft Endowment Fund. We acknowledge the contributions of Melissa Colthrust, MS and Claudia Kelp-Lenane, PT for editing this manuscript.