scholarly journals Adherence to modified constraint-induced movement therapy: the case for meaningful occupation

2016 ◽  
Vol 8 (3) ◽  
pp. 263 ◽  
Author(s):  
Johanne Walker ◽  
Melanie Moore
Keyword(s):  
Upper Limb ◽  
Qualitative Case Study ◽  
Movement Therapy ◽  
Self Esteem ◽  
Case Study Design ◽  
Upper Limb Function ◽  
Constraint Induced Movement Therapy ◽  
Factors Influencing ◽  
Upper Limb Hemiparesis

ABSTRACT INTRODUCTION Modified constraint-induced movement therapy (mCIMT) has been shown to improve function of an affected upper limb post stroke. However, factors influencing adherence of individuals undertaking a mCIMT protocol require further investigation. AIM To explore the experience of two participants undergoing a mCIMT protocol and examine factors influencing adherence to the protocol. METHODS A qualitative case study design was used. Two participants with upper limb hemiparesis following a stroke were recruited and received mCIMT (two hours of therapy, three days per week for a total of two weeks). During the treatment period, participants were also encouraged to wear the restraint mitt for four hours per day at home. RESULTS Participants reported increased confidence and self-esteem following participation, as well as improvements in bi-lateral upper limb function. Participants reported the mCIMT protocol as being highly frustrating. However, motivation to adhere to the protocol was positively influenced by the meaningfulness of the occupations attempted. CONCLUSION Although mCIMT can prove frustrating, meaningful occupations may act as a powerful motivator towards adherence to a mCIMT protocol. Further research is required.

scholarly journals Upper limb therapy in children with cerebral palsy (CP) – The Pirate Group

2017 ◽  
Vol 31 (4) ◽  
pp. 57-67
Author(s):  
Marta Pawlak ◽  
Beata Wnuk ◽  
Daniela Kowalicka ◽  
Aleksandra Rosłoniec
Keyword(s):  
Cerebral Palsy ◽  
Upper Limb ◽  
Movement Therapy ◽  
Limb Function ◽  
Upper Limb Function ◽  
Constraint Induced Movement Therapy ◽  
Significant Difference ◽  
Children With Cerebral Palsy ◽  
Bimanual Training ◽  
Spastic Hemiplegia

Abstract Introduction: Children with cerebral palsy (CP) in the form of spastic hemiplegia experience numerous difficulties concerning an affected upper limb such as reaching for objects, gripping or manipulating them. These limitations affect their everyday activity. Conducting an effective and simultaneously an interesting therapy aimed at meeting the child’s individual needs and improving upper limb function is a challenge for a physiotherapist. The aim of the study was to assess the effectiveness of upper limb therapy carried out within the project titled “The Pirate Group” based on Constraint-Induced Movement Therapy (CIMT) and Bimanual Training (BIT) conducted in a specially arranged environment. Material and methods: The research included 16 children with CP in the form of spastic hemiplegia. Mean age of the study participants was 4.23 years. The children underwent a two-week Constraint-Induced Movement Therapy (CIMT) combined with Bimanual Training (BIT). In order to evaluate the effects of the therapy, each child underwent the Assisting Hand Assessment (AHA) prior to the therapy and after its completion. Results: Statistical analysis revealed a significant difference (p<0.05) between the results of AHA prior to and after the therapy (t(14)=9.12, p<0.0001). An improvement in the affected upper limb function was noted in all the children participating in the research. Conclusions: The project titled “The Pirate Group”, based on CIMT and BIT is an effective therapeutic intervention which improves spontaneous activity of the affected upper limb in children with hemiplegia.

scholarly journals Constraint-induced movement therapy for recovery of upper-limb function following traumatic brain injury

2005 ◽  
Vol 42 (6) ◽  
pp. 769 ◽  
Author(s):  
Sharon E. Shaw ◽  
David M. Morris ◽  
Gitendra Uswatte ◽  
Staci McKay ◽  
Jay M. Meythaler ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Upper Limb ◽  
Movement Therapy ◽  
Limb Function ◽  
Upper Limb Function ◽  
Constraint Induced Movement Therapy

scholarly journals A randomized controlled trial to compare two methods of constraint-induced movement therapy to improve functional ability in the affected upper limb in pre-school children with hemiplegic cerebral palsy: CATCH TRIAL

2018 ◽  
Vol 32 (7) ◽  
pp. 909-918 ◽  
Author(s):  
Pauline M Christmas ◽  
Catherine Sackley ◽  
Max G Feltham ◽  
Carole Cummins
Keyword(s):  
Randomized Controlled Trial ◽  
Cerebral Palsy ◽  
Upper Limb ◽  
Controlled Trial ◽  
Movement Therapy ◽  
Randomized Controlled ◽  
Upper Limb Function ◽  
Constraint Induced Movement Therapy ◽  
Hemiplegic Cerebral Palsy

Objective: To determine the feasibility and short-term efficacy of caregiver-directed constraint-induced movement therapy to improve upper limb function in young children with hemiplegic cerebral palsy. Design: Randomized controlled trial with masked assessment. Setting: Community paediatric therapy services. Subjects: Pre-school children with hemiplegic cerebral palsy. Interventions: Caregiver-directed constraint-induced movement therapy administered using either 24-hour short-arm restraint device (prolonged) or intermittent holding restraint during therapy (manual). Main measures: Primary measures include Assisting Hand Assessment (AHA) at 10 weeks. Secondary measures include adverse events, Quality of Upper Extremity Skills Test and Pediatric Quality of Life Inventory. Feasibility measures include recruitment, retention, data completeness and adherence. Results: About 62/81 (72%) of eligible patients in 16 centres were randomized (prolonged restraint n = 30; manual restraint n = 32) with 97% retention at 10 weeks. The mean change at 10 weeks on the AHA logit-based 0–100 unit was 9.0 (95% confidence interval (CI): 5.7, 12.4; P < 0.001) for prolonged restraint and 5.3 (95% CI: 1.3, 9.4; P = 0.01) for manual restraint with a mean group difference of 3.7 (95% CI: −1.5, 8.8; P = 0.156) (AHA smallest detectable difference = 5 units). No serious related adverse events were reported. There were no differences in secondary outcomes. More daily therapy was delivered with prolonged restraint (60 vs 30 minutes; P < 0.001). AHA data were complete at baseline and 10 weeks. Conclusion: Caregiver-directed constraint-induced movement therapy is feasible and associated with improvement in upper limb function at 10 weeks. More therapy was delivered with prolonged than with manual restraint, warranting further testing of this intervention in a longer term trial.

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