Constraint-induced movement therapy for a child with hemiparesis: a case report

Abstract

This case report describes the outcomes of a method of constraint-induced movement therapy (CIMT) incorporated into a home program using a minimally restrictive constraint over an 18-month period. The movement of the uninvolved hand and wrist of a 13-month-old child with hemiparesis was constrained with a soft removable mitt. Caregivers performed CIMT in 2 intense periods and weaning periods, and a home exercise period. Two independent raters performed video analysis of the quantity and quality of upper extremity. All measures showed improvement. Reaches with the involved upper extremity increased from 8.9% to 41.0%. Use of advanced grasp patterns increased from 3.3% to 76.1%. Successful release of objects improved from 0% to 73.0%. Caregivers reported functional improvements and strong positive feedback regarding success, ease, and satisfaction with CIMT. This case demonstrates positive outcomes using a clinically feasible method of CIMT with far reaching implications on function.