Effect of constraint-induced therapy on upper limb functions: A randomized control trial

Abstract

Aims: Children with congenital hemiparesis have unilateral upper extremity involvement, limiting their ability in unilateral or bilateral manual tasks, thus negatively influencing their participation in daily activities. Constraint-induced movement therapy (CIMT) has been shown to be promising for improving upper-limb functions in children with cerebral palsy. Clinical assessments may be needed to quantify and qualify changes in children's performance following its application. Methods: This study investigated the effectiveness of a child-friendly form of CIMT to improve upper extremity functional performance. Thirty congenitally hemiparetic children aged 4–8 years were randomly assigned to receive either a CIMT program (study group) or a conventional non-structured therapy program (control group). The programs were applied for both groups for six hours daily, five days weekly for four successive weeks. The Pediatric Arm Function Test, Quality of Upper Extremity Skills Test, and isokinetic muscular performances of shoulder flexors, extensors, and abductors expressed as peak torque were used to evaluate immediate and long-lasting efficacy of CIMT. Results: The results showed improvement in the involved upper extremity performances in different evaluated tasks immediately post-CIMT program application compared with the control group. These improvements continued three months later. Conclusion: Pediatric CIMT with shaping produced considerable and sustained improvement in the involved upper extremity movements and functions in children with congenital hemiparesis.

Key words::

• cerebral palsy
• congenital hemiparesis
• constraint-induced movement therapy
• pediatric rehabilitation
• upper extremity

Acknowledgment

The authors wish to acknowledge their gratitude to the participating children, their parents, and the volunteer occupational and physical therapist colleagues. Their contributions to the evaluation and intervention phases were crucial to accomplish this study.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.