Constraint-induced movement therapy for children with acquired brain injury: didactical approach and functional change

Abstract

An estimated 125–137 Danish children with acquired brain injury (ABI) require rehabilitation annually, 30–40 of these at a highly specialized level. Constraint-induced movement therapy (CIMT) has shown significant effects in increasing function in children with cerebral palsy. More knowledge of how CIMT can be adapted for the rehabilitation of children with ABI is needed. The primary purpose of the study was to generate new knowledge about the pedagogical initiatives and frameworks involved in children’s participation in and activities during CIMT. Four children with ABI participated in the 60 h intervention. Data generation consisted of qualitative research through participant observations and healthcare professional evaluations. A didactical approach with individualization and a solid structural framework enhanced the possibility of securing the children’s motivation for and participation in the intervention. Adaptation, compensation and individualization were crucial factors in the achievement of changes in functional skills. Spontaneous functional use and natural bimanual involvement increased, indicating that CIMT intervention encourages the retrieval of natural involvement of the impaired upper limb after ABI. Individualization, attention, firm structure and goal-specific tasks are key didactical factors to maintain children’s motivation to participate during CIMT to increase functional skills and spontaneous and natural bimanual involvement of the impaired upper limb during activities.

Keywords:

• Activity of daily living
• didactical framework
• didactical key factors
• rehabilitation

Acknowledgements

A special thank you goes to the children, their families and the health professionals who took the time and trouble to participate in this research. Additional thanks goes to Tove Kristensen for taking part in literature scoring.

Disclosure statement

The authors report no conflicts of interest.

Funding information

The study was funded by Hammel Neurorehabilitation and Research Centre and supported by the Danish Physiotherapists’ Britta Holles Fund.