The current standard-of-care for children with cerebral palsy often consists of a blend of occupational and physical therapy. But what if another therapy could be more beneficial? Medical XPress describes how, in a clinical trial funded by the National Institutes of Health (NIH), researchers determined that Constraint-Induced Movement Therapy (CIMT) could have increased benefits for patients with cerebral palsy. In particular, this form of therapy improved mobility and upper extremity skills for children with hemiparetic cerebral palsy, or cerebral palsy affecting one side of the body. Because this showed promise over the current standards-of-care, researchers suggest that CIMT could be implemented as a helpful therapeutic tool moving forward.

CIMT

So what exactly is Constraint-Induced Movement Therapy (CIMT)? As described by Physiopedia, CIMT is:

a new treatment technique that claims to improve the arm motor ability and the functional use of a paretic arm – hand. CIMT forces the use of the affected side by restraining the unaffected side.

In short, CIMT works by constraining the unaffected arm and hand, while having patients participate in activities to build movement, strength, and skills in the affected arm. The arm may be constrained using a sling, cast, splint, or a mitt. Patients may wear the constraining device on their unaffected arm during a majority of their waking hours while also participating in sessions of intensive and repetitive training with the other arm.

Within this study, researchers wanted to understand the difference between CIMT “doses,” or the length of time in which patients were being treated. During the trial, 118 children (ages 2-8) were enrolled. Patients were either placed into the control group or one of four treatment groups. These treatment groups were as followed:

• 30 hours CIMT treatment in a splint // 30 hours CIMT treatment in a cast
• 60 hours CIMT treatment in a splint // 60 hours CIMT treatment in a cast

Ultimately, this breakdown was either 3-hour CIMT sessions for 5 days a week, for a 1-month period, or 2.5-hour CIMT sessions for 3 days a week, for a 1-month period. Findings included:

• Patients receiving “high-dose” therapy saw improvements in object manipulating, grasping, moving, and other similar skills.
• While patients receiving the “lower-dose” still improved, there was no significant improvement compared to the control group who received the standards-of-care. However, this control group also improved more heavily than researchers expected.

Cerebral Palsy

Cerebral palsy is a neurological movement disorder. Typically, injury at birth, during development in the womb, or within the first 2 years of life causes cerebral palsy. Maternal infections, fetal stroke, traumatic head injury, and genetic mutations may all play a role. Regardless, cerebral palsy causes a lack of muscle control and impaired functional abilities. Some symptoms and characteristics include:

• Too stiff or too loose muscles
• Difficulty walking, swallowing, speaking, performing precise movements, or eating
• Excessive drooling
• Intellectual disabilities
• Vision and hearing difficulties
• Speech development and motor milestone delays
• Muscle spasticity or rigidity
• Seizures
• Slow, writhing movements called athetosis
• Lack of muscle coordination
• Urinary incontinence

To learn more about cerebral palsy, click here.