constraint-induced movement therapy

Constraint Induced Movement Therapy (CIMT) is one of the effective methods in improving motor function of upper extremity in children with spastic hemiplegic cerebral palsy, which has various types. The objective of the present integrated review was to investigate the effect of CIMT in children with spastic hemiplegic cerebral palsy and to create specific instruction for using this method for these children.

In the present combined and two-stage study, first, in an integrated review, all articles in Persian and English languages between 2000 and 2015 on children with spastic hemiplegic cerebral palsy were extracted using the following keywords: cerebral palsy, hemiplegia, Constraint Induced Movement Therapy, rehabilitation, and occupational therapy. Then, in the qualitative stage, the results were examined in the five-member expert panel of professional occupational therapists in the area of cerebral palsy.

In the conducted investigation, 36 articles were found related on cerebral palsy and upper extremity function. First, by examining the summary of articles, only 14 articles that met the inclusion criteria were selected. Then, full texts of articles related to interventions CIMT to improve hand function of patients with cerebral palsy were examined.

In the investigations conducted, the positive impact of CIMT in improving the motor function of children with cerebral palsy had been proven, but the results were not provided as an instruction. Therefore, with regard to the view of experts and specialists, a specific instruction for this treatment was developed. In addition, the impact of this treatment with a sling or splint for 14 days, 6 hours a day along with occupational therapy, and physiotherapy was more.

Effectiveness of Constraint Induced Movement Therapy (CIMT) has been approved in adult persons، while it seems that we need many researches with higher levels of evidence based in children. This research aimed to identify efficacy of CIMT on unimanual and bimanual function in children with Cerebral Palsy.

In this interventional study، were applied twenty eight participants were selected that had inclusion and exclusion criteria and then divided in two groups CIMT and control. The intervention was provided on 10 out of 12 consecutive days in CIMT group and another group was received occupational therapy services. Assessment tools which were utilized in the survey were Bruininks-Oseretsky Motor Proficiency Test، Caregiver Functional Use Survey (CFUS)، Jebsen-Taylor Test in Hand Function. In order to compare two groups Independent t-test was used and to compare each group from pre-test to post-test paired t-test was utilized.

Data showed significant differences between two groups in dexterity، bilateral coordination، bimanual coordination، bimanual function، unimanual function and Caregiver Functional Use Survey (how well & how frequently) (p<0. 05). Also comparison between pre-test and post-test in each group presented improvement in most of data in research.

protocol of child friendly Constraint Induced Movement Therapy was lead to improvement in either unimanual or bimanual hand function in children with cerebral palsy.