Constraint-induced movement therapy of upper limb of children with cerebral palsy in clinical practice: systematic review of the literature

ABSTRACT The purpose of the present study was to perform a systematic review of the literature to investigate how and with what modifications or adaptations constraint-induced movement therapy has been employed in clinical practice for therapeutic interventions in children with cerebral palsy. Searches were conducted of the CAPES (Brazilian fostering agency) periodical portal, Pubmed, Bireme, Science Direct, Scielo and PEDro databases for relevant articles published between January 2010 and May 2016. The articles retrieved were evaluated, scored and qualified by two blinded reviewers using the Physical therapy Evidence Database Scale. The searches led to the retrieval of 102 articles, 12 of which were included in the present systematic review. A table was created containing information on the study groups, inclusion criteria, intervention, intervention frequency, difficulties encountered, evaluations and outcomes. Considerable variety was found in the therapeutic intervention models. The findings of the present review demonstrate that constraint-induced movement therapy in pediatric clinical practice is not employed in its original form. Although the studies analyzed did not have a common methodology regarding the use of this type of therapy, the method has been adapted with considerable flexibility, providing promising, positive results regarding the therapeutic intervention of the paretic upper limb in children with cerebral palsy.

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Constraint-induced movement therapy improves upper limb activity and participation in hemiplegic cerebral palsy: a systematic review

Journal of Physiotherapy ◽

10.1016/j.jphys.2016.05.013 ◽

2016 ◽

Vol 62 (3) ◽

pp. 130-137 ◽

Cited By ~ 34

Author(s):

Hsiu-Ching Chiu ◽

Louise Ada

Keyword(s):

Systematic Review ◽

Cerebral Palsy ◽

Upper Limb ◽

Movement Therapy ◽

Constraint Induced Movement Therapy ◽

Hemiplegic Cerebral Palsy

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

Advances in Rehabilitation ◽

10.1515/rehab-2015-0079 ◽

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.

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