Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2011 Sep;26(9):1163-73.
doi: 10.1177/0883073811408423. Epub 2011 Jul 19.

Treatment of congenital hemiparesis with pediatric constraint-induced movement therapy

Edward Taub  1 , Angi Griffin, Gitendra Uswatte, Kristin Gammons, Jennifer Nick, Charles R Law
Affiliations
Randomized Controlled Trial

Treatment of congenital hemiparesis with pediatric constraint-induced movement therapy

Edward Taub et al. J Child Neurol. 2011 Sep.

Abstract

To determine efficacy of pediatric Constraint-Induced Movement therapy, 20 children with congenital hemiparesis (ages 2 to 6 years) were randomly assigned to receive the treatment or usual care. Controls crossed over to the therapy after 6 months. Children receiving the therapy first exhibited emergence of more new classes of motor patterns and skills (eg, crawling, thumb-forefinger prehension; 6.4 vs 0.02, P < .0001, effect size d = 1.3), and demonstrated significant gains in spontaneous use of the more affected arm at home (2.2 vs 0.1, P < .0001, d = 3.8) and in a laboratory motor function test. Depending on the measure, benefits were maintained (range, no loss to 68% retention over 6 months). When controls crossed over to the therapy, they exhibited improvements as great as or greater than those receiving therapy first. Thus, Constraint-Induced Movement therapy appears to be efficacious for young children with hemiparesis consequent to congenital stroke.

PubMed Disclaimer

Figures

Figure A
Figure A
Top panel. Pre-Constraint-Induced therapy—Self-feeding with a spoon. Limitations: weak grasp, no active wrist extension, needs assistance to pick up spoon and lift it to mouth, unable to turn wrist to get food in mouth.
Figure B
Figure B
Bottom panel. Post-Constraint-Induced therapy—Self-feeding with a spoon. Changes: successful on first attempt, improved wrist extension, independent in grasping spoon and bringing it to mouth, improved trunk stability.
Figure 1
Figure 1
Spontaneous use of the more impaired arm (Pediatric Motor Activity Log score) for the Immediate Constraint-Induced Therapy Group and the Control Group before and after crossover to constraint-induced therapy. Data for the Immediate Constraint-Induced Therapy Group are shown for treatment and 1, 6, and 12 months after treatment. Data for the control subjects are shown for 6 months after treatment, at which time they were crossed over to constraint-induced therapy. After crossover data are shown for treatment and 1 and 6 months afterward. Abbreviations: CI, constraint-induced; PMAL, Pediatric Motor Activity Log.
See this image and copyright information in PMC

References

    1. Bax M. Terminology and classification of cerebral palsy. Dev Med Child Neurol. 1964;6:295–307. - PubMed
    1. Chabrier S, Roubertie A, Allard D, et al. New developments in spastic unilateral cerebral palsy. Rev Neurol (Paris) 2010;166:565–573. - PubMed
    1. Kirton A, de Veber G. Cerebral palsy secondary to perinatal ischemic stroke. Clin Perinatol. 2006;33:367–386. - PubMed
    1. Boyd RN, Morris ME, Graham HK. Management of upper limb dysfunction in children with cerebral palsy: a systematic review. Eur J Neurol. 2001;8:150–166. - PubMed
    1. Barry M. Evidence-based practice in pediatric physical therapy. Phys Ther. 2001;9:39–51.

Publication types