Sunday, July 11, 2010

Adapted Constraint Induced Therapy

Clinical Rehabilitation published research on an adapted version of constraint-induced movement therapy to promote functioning in children with cerebral palsy. Sixteen children with cerebral palsy (mean age 5 years 6 months) participated in constraint induced therapy for 2 weeks. The control group received the usual rehabilitation services during the 2 weeks. The intervention group had the non-involved extremity restricted for 10 hours per day with 3 hours of intensive training with the affected extremity. The experimental group also received bimanual functional training for one week following the constraint therapy. The self care domain of the Pediatric Evaluation of Disability Inventory and an adapted version of the Jebsen—Taylor test were completed at the start of the intervention, following completion of the intervention and at one month follow up.

Results indicated higher gains in the experimental group for functional skills and Independence. No differences were found in manual dexterity between the two groups.

References: Marina de Brito Brandão, Marisa Cotta Mancini, Daniela Virgínia Vaz, Ana Paula Pereira de Melo, and Sérgio Teixeira Fonseca Adapted version of constraint-induced movement therapy promotes functioning in children with cerebral palsy: a randomized controlled trial Clin Rehabil 2010 24: 639-647

2 comments:

TherExtras said...

I would like to see more press for this study and for CIT. Yes, it is a small n. But functional skills is more meaningful than a measurement of dexterity - my opinion. I also think the PEDI is an excellent standardized tool.

I also need to mention the intensity issue - for results of any activity based or exercise treatment intervention, intensity is a key factor for results. But, if the only difference between how the 2 groups were treated was that the CIT group had a restrained UE, then intensity is not a factor.

Thanks for this, Margaret.
Barbara

Your Therapy Source Inc said...

Confused about your intensity statement. My opinion is that intensity plays a huge role - the constraint group undergoes 10 hrs per day with 3 intensive training periods of the uninvolved extremity. To me that indicates that direct therapy services only performed 1-3x/ week can't even touch the surface regarding the amount of practice necessary to make changes. Thoughts??