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Meta-Analysis
. 2019 Apr 1;4(4):CD004149.
doi: 10.1002/14651858.CD004149.pub3.

Constraint-induced movement therapy in children with unilateral cerebral palsy

Brian J Hoare  1 , Margaret A Wallen, Megan N Thorley, Michelle L Jackman, Leeanne M Carey, Christine Imms
Affiliations
Meta-Analysis

Constraint-induced movement therapy in children with unilateral cerebral palsy

Brian J Hoare et al. Cochrane Database Syst Rev. .

Abstract

Background: Unilateral cerebral palsy (CP) is a condition that affects muscle control and function on one side of the body. Children with unilateral CP experience difficulties using their hands together secondary to disturbances that occur in the developing fetal or infant brain. Often, the more affected limb is disregarded. Constraint-induced movement therapy (CIMT) aims to increase use of the more affected upper limb and improve bimanual performance. CIMT is based on two principles: restraining the use of the less affected limb (for example, using a splint, mitt or sling) and intensive therapeutic practice of the more affected limb.

Objectives: To evaluate the effect of constraint-induced movement therapy (CIMT) in the treatment of the more affected upper limb in children with unilateral CP.

Search methods: In March 2018 we searched CENTRAL, MEDLINE, Embase, CINAHL, PEDro, OTseeker, five other databases and three trials registers. We also ran citation searches, checked reference lists, contacted experts, handsearched key journals and searched using Google Scholar.

Selection criteria: Randomised controlled trials (RCTs), cluster-RCTs or clinically controlled trials implemented with children with unilateral CP, aged between 0 and 19 years, where CIMT was compared with a different form of CIMT, or a low dose, high-dose or dose-matched alternative form of upper-limb intervention such as bimanual intervention. Primarily, outcomes were bimanual performance, unimanual capacity and manual ability. Secondary outcomes included measures of self-care, body function, participation and quality of life.

Data collection and analysis: Two review authors independently screened titles and abstracts to eliminate ineligible studies. Five review authors were paired to extract data and assess risk of bias in each included study. GRADE assessments were undertaken by two review authors.

Main results: We included 36 trials (1264 participants), published between 2004 and 2018. Sample sizes ranged from 11 to 105 (mean 35). Mean age was 5.96 years (standard deviation (SD) 1.82), range three months to 19.8 years; 53% male and 47% participants had left hemiplegia. Fifty-seven outcome measures were used across studies. Average length of CIMT programs was four weeks (range one to 10 weeks). Frequency of sessions ranged from twice weekly to seven days per week. Duration of intervention sessions ranged from 0.5 to eight hours per day. The mean total number of hours of CIMT provided was 137 hours (range 20 to 504 hours). The most common constraint devices were a mitt/glove or a sling (11 studies each).We judged the risk of bias as moderate to high across the studies.

Key results: Primary outcomes at primary endpoint (immediately after intervention)CIMT versus low-dose comparison (e.g. occupational therapy)We found low-quality evidence that CIMT was more effective than a low-dose comparison for improving bimanual performance (mean difference (MD) 5.44 Assisting Hand Assessment (AHA) units, 95% confidence interval (CI) 2.37 to 8.51).CIMT was more effective than a low-dose comparison for improving unimanual capacity (Quality of upper extremity skills test (QUEST) - Dissociated movement MD 5.95, 95% CI 2.02 to 9.87; Grasps; MD 7.57, 95% CI 2.10 to 13.05; Weight bearing MD 5.92, 95% CI 2.21 to 9.6; Protective extension MD 12.54, 95% CI 8.60 to 16.47). Three studies reported adverse events, including frustration, constraint refusal and reversible skin irritations from casting.CIMT versus high-dose comparison (e.g. individualised occupational therapy, bimanual therapy)When compared with a high-dose comparison, CIMT was not more effective for improving bimanual performance (MD -0.39 AHA Units, 95% CI -3.14 to 2.36). There was no evidence that CIMT was more effective than a high-dose comparison for improving unimanual capacity in a single study using QUEST (Dissociated movement MD 0.49, 95% CI -10.71 to 11.69; Grasp MD -0.20, 95% CI -11.84 to 11.44). Two studies reported that some children experienced frustration participating in CIMT.CIMT versus dose-matched comparison (e.g. Hand Arm Bimanual Intensive Therapy, bimanual therapy, occupational therapy)There was no evidence of differences in bimanual performance between groups receiving CIMT or a dose-matched comparison (MD 0.80 AHA units, 95% CI -0.78 to 2.38).There was no evidence that CIMT was more effective than a dose-matched comparison for improving unimanual capacity (Box and Blocks Test MD 1.11, 95% CI -0.06 to 2.28; Melbourne Assessment MD 1.48, 95% CI -0.49 to 3.44; QUEST Dissociated movement MD 6.51, 95% CI -0.74 to 13.76; Grasp, MD 6.63, 95% CI -2.38 to 15.65; Weightbearing MD -2.31, 95% CI -8.02 to 3.40) except for the Protective extension domain (MD 6.86, 95% CI 0.14 to 13.58).There was no evidence of differences in manual ability between groups receiving CIMT or a dose-matched comparison (ABILHAND-Kids MD 0.74, 95% CI 0.31 to 1.18). From 15 studies, two children did not tolerate CIMT and three experienced difficulty.

Authors' conclusions: The quality of evidence for all conclusions was low to very low. For children with unilateral CP, there was some evidence that CIMT resulted in improved bimanual performance and unimanual capacity when compared to a low-dose comparison, but not when compared to a high-dose or dose-matched comparison. Based on the evidence available, CIMT appears to be safe for children with CP.

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Conflict of interest statement

Brian Hoare* is employed by Monash Health. In 2014, he received an honorarium from Allergan Australia for travel to Sri Lanka as part of a multi‐disciplinary team to teach and train local physicians and therapists in the management of the upper limb in children with CP. The honoraria covered flights and accommodation for the trip, which were paid for directly by Allergan. This update does not review products manufactured by Allergan and Brian Hoare has no personal financial interest in Allergan, Botox®, or any related product.

*Brian Hoare, Christine Imms and Leeanne Carey are authors on the included study Hoare 2013, and were not involved in assessing the eligibility of this study for inclusion, extracting data from this study for purposes of this review, assessing the risk of bias in this study, or grading the quality of the evidence from this study.

Margaret Wallen is an author on the included study Wallen 2011 and was not involved in assessing the eligibility of this study for inclusion, extracting data from this study, assessing the risk of bias in this study, or grading the quality of the evidence from this study.

Megan Thorley ‐ none known.

Michelle Jackman ‐ none known.

Leeanne Carey* ‐ none known.

Christine Imms* is employed by the Australian Catholic University (ACU). ACU has provided support to CI for travel to conferences in which presentations were made about research in CP. CI received a philanthropic travel grant and other support from her university employer for unrelated studies.

Figures

1
1
Study flow diagram
2
2
'Risk of bias' summary: Review authors' judgements about each 'Risk of bias' item for each included study. Note: Not all studies used self‐reported outcome measures, so a 'Risk of bias' rating could not be ascribed. This explains the absence of ratings for some of the studies. No ratings are entered for Kirton 2016b (CIMT + sham TMS), as it is the same study as Kirton 2016a (CIMT + r TMS), immediately above it in the 'Risk of bias' summary.
3
3
'Risk of bias' graph: Review authors' judgements about each 'Risk of bias' item presented as percentages across all included studies. Note: Not all studies used self‐reported outcome measures, so a 'Risk of bias' rating could not be ascribed. This explains the absence of data in the corresponding domain in this graph. The total risk is < 100% because data were entered only once for Kirton 2016a (CIMT + r TMS) and Kirton 2016b (CIMT + sham TMS).
See this image and copyright information in PMC

Update of

Comment in

References

References to studies included in this review

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de Brito Brandão 2010 {published and unpublished data}
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Dong 2017 {published and unpublished data}
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Kirton 2016a (CIMT + r TMS) {published and unpublished data}
    1. Kirton A, Andersen J, Herrero M, Carsolio L, Nettel‐Aguirre A, Keess J, et al. Brain stimulation and constraint for perinatal stroke hemiparesis: the PLASTIC CHAMPS trial. European Journal of Paediatric Neurology 2015;19(Suppl 1):S10. [DOI: 10.1016/S1090-3798(15)30030-1; NCT01189058; OP29 – 2815] - DOI - PMC - PubMed
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Kirton 2016b (CIMT + sham TMS) {published and unpublished data}
    1. Kirton A, Andersen J, Herrero M, Nettel‐Aguirre A, Carsolio L, Damji O, et al. Brain stimulation and constraint for perinatal stroke hemiparesis: the PLASTIC CHAMPS trial. Neurology 2016;86(18):1659‐67. [DOI: 10.1212/WNL.0000000000002646; NCT01189058; PMC4854585 ; PUBMED: 27029628] - DOI - PMC - PubMed
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Rostami 2012b {published and unpublished data}
    1. Rostami HR, Arastoo AA, Nejad SJ, Mahany MK, Malamiri, RA, Goharpey S. Effects of modified constraint‐induced movement therapy in virtual environment on upper‐limb function in children with spastic hemiparetic cerebral palsy: a randomised controlled trial. NeuroRehabilitation 2012;31(4):357–65. [DOI: 10.3233/NRE-2012-00804; PUBMED: 23232158] - DOI - PubMed
    1. Rostami HR, Arastoo AA, Nejad SJ, Malamiri RA, Mahany MK, Goharpey S. Efficacy of combined virtual reality with constraint‐induced movement therapy on upper limb function of children with hemiparetic cerebral palsy. Journal of Research in Rehabilitation Sciences 2011;7(4):499‐508. [www.sid.ir/En/Journal/ViewPaper.aspx?ID=255960]
Sabour 2012 {published data only}
    1. Sabour HE, Rassafiani M, Hosseini SA, Akbarfahimi N, Karimloo M. The effect of combination of constraint induced movement therapy with bimanual intensive therapy on upper limb function of children with hemiplegic cerebral palsy. Journal of Research in Rehabilitation Sciences 2012;8(Suppl 8):1312‐8. [sid.ir/En/Journal/ViewPaper.aspx?ID=350278]
Sakzewski 2011 {published and unpublished data}
    1. Boyd R, Sakzewski L, Ziviani J, Abbott DF, Badawy R, Gilmore R, et al. INCITE: a randomised trial comparing constraint induced movement therapy and bimanual training in children with congenital hemiplegia. BMC Neurology 2010;10:4. [DOI: 10.1186/1471-2377-10-4; ACTRN12609000912280; PMC2832893 ; PUBMED: 20064275] - DOI - PMC - PubMed
    1. Gilmore R, Ziviani J, Sakzewski L, Shields N, Boyd RN. A balancing act: children's experience of modified constraint‐induced movement therapy. Developmental Neurorehabilitation 2010;13(2):88‐94. [DOI: 10.3109/17518420903386161; ACTRN12609000912280; PUBMED: 20222769] - DOI - PubMed
    1. Sakzewski L, Carlon S, Shields N, Ziviani J, Boyd R. Impact of intensive upper limb rehabilitation on quality of life in a randomised trial for children with congenital hemiplegia. Developmental Medicine & Child Neurology 2012;54(Suppl 5):28‐9. [DOI: 10.1111/j.1469-8749.2012.04289.x; ACTRN12609000912280; F2.G3] - DOI - PubMed
    1. Sakzewski L, Carlon S, Shields N, Ziviani J, Ware RS, Boyd RN. Impact of intensive upper limb rehabilitation on quality of life: a randomized trial in children with unilateral cerebral palsy. Developmental Medicine & Child Neurology 2012;54(5):415‐23. [DOI: 10.1111/j.1469-8749.2012.04272.x; ACTRN12609000912280; PUBMED: 22429002] - DOI - PubMed
    1. Sakzewski L, Ziviani J, Abbott DF, Macdonell RA, Jackson GD, Boyd RN. Equivalent retention of gains at 1 year after training with constraint‐induced or bimanual therapy in children with unilateral cerebral palsy. Neurorehabilitation and Neural Repair 2011;25(7):664‐71. [DOI: 10.1177/1545968311400093; ACTRN12609000912280; PUBMED: 21427273] - DOI - PubMed
Sakzewski 2015a {published and unpublished data}
    1. Boyd RN, Ziviani J, Sakzewski L, Miller L, Bowden J, Cunnington R, et al. COMBIT: protocol of a randomised comparison trial of COMbined modified constraint induced movement therapy and bimanual intensive training with distributed model of standard upper limb rehabilitation in children with congenital hemiplegia. BMC Neurology 2013;13:68. [DOI: 10.1186/1471-2377-13-68; ACTRN12613000181707; PMC3750247; PUBMED: 23809257] - DOI - PMC - PubMed
    1. Miller L, Ziviani J, Ware RS, Boyd RN. Does context matter? Mastery motivation and therapy engagement of children with cerebral palsy. Physical & Occupational Therapy in Pediatrics 2016;36(2):155‐70. [DOI: 10.3109/01942638.2015.1076556; ACTRN12613000181707; PUBMED: 26565438] - DOI - PubMed
    1. Miller L, Ziviani J, Ware RS, Boyd RN. Mastery motivation as a predictor of occupational performance following upper limb intervention for school‐aged children with congenital hemiplegia. Developmental Medicine & Child Neurology 2014;56(10):976‐83. [DOI: 10.1111/dmcn.12471; ACTRN12613000181707; PUBMED: 24766637] - DOI - PubMed
    1. Miller L, Ziviani J, Ware RS, Boyd RN. Mastery motivation in children with congenital hemiplegia: individual and environmental associations. Developmental Medicine & Child Neurology 2014;56(3):267‐74. [DOI: 10.1111/dmcn.12356; PUBMED: 24341437] - DOI - PubMed
    1. Miller L, Ziviani J, Ware RS, Boyd RN. Mastery motivation: a way of understanding therapy outcomes for children with unilateral cerebral palsy. Disability and Rehabilitation 2015;37(16):1439‐45. [DOI: 10.3109/09638288.2014.964375; ACTRN12613000181707; PUBMED: 25259559 ] - DOI - PubMed
Sakzewski 2015b {published and unpublished data}
    1. Sakzewski L, Provan K, Ziviani J, Boyd RN. Comparison of dosage of intensive upper limb therapy for children with unilateral cerebral palsy: how big should the therapy pill be?. Research in Developmental Disabilities 2015;37:9‐16. [DOI: 10.1016/j.ridd.2014.10.050; PUBMED: 25460215] - DOI - PubMed
Smania 2009 {published data only}
    1. Smania N, Aglioti SM, Cosentino A, Camin M, Gandolfi M, Tinazzi M, et al. A modified constraint‐induced movement therapy (CIT) program improves paretic arm use and function in children with cerebral palsy. European Journal of Physical and Rehabilitation Medicine 2009;45(4):493‐500. [NCT00473447; PUBMED: 20032907] - PubMed
Sung 2005 {published data only}
    1. Sung IY, Ryu JS, Pyun SB, Yoo SD, Song WH, Park MJ. Efficacy of forced‐use therapy in hemiplegic cerebral palsy. Archives of Physical Medicine and Rehabilitation 2005;86(11):2195‐8. [DOI: 10.1016/j.apmr.2005.05.007; PUBMED: 16271570] - DOI - PubMed
Taub 2004 {published and unpublished data}
    1. DeLuca S. Intensive Movement Therapy with Casting for Children with Hemiparetic Cerebral Palsy: A Randomised Controlled Trial [Dissertation]. Birmingham (US): University of Alabama at Birmingham, 2002. [NCT00061139]
    1. DeLuca SC, Echols K, Law CR, Ramey SL. Intensive pediatric constraint‐induced therapy for children with cerebral palsy: randomized, controlled, crossover trial. Journal of Child Neurology 2006;21(11):931‐8. [DOI: 10.1177/08830738060210110401; NCT00061139; PUBMED: 17092457] - DOI - PubMed
    1. Taub E, Ramey SL, DeLuca S, Echols K. Efficacy of constraint‐induced movement therapy for children with cerebral palsy with asymmetric motor impairment. Pediatrics 2004;113(2):305‐12. [NCT00061139; PUBMED: 14754942] - PubMed
Taub 2011 {published data only (unpublished sought but not used)}
    1. Taub E, Griffin A, Uswatte G, Gammons K, Nick J, Law CR. Treatment of congenital hemiparesis with pediatric constraint‐induced movement therapy. Journal of Child Neurology 2011;26(9):1163‐73. [DOI: 10.1177/0883073811408423; PMC3674837; PUBMED: 21771948] - DOI - PMC - PubMed
Wallen 2011 {published and unpublished data}
    1. Wallen M, Ziviani J, Naylor O, Evans R, Novak I, Herbert RD. Modified constraint‐induced therapy for children with hemiplegic cerebral palsy: a randomized trial. Developmental Medicine & Child Neurology 2011;53(12):1091‐9. [DOI: 10.1111/j.1469-8749.2011.04086.x; ACTRN12607000446460; PUBMED: 21923854] - DOI - PubMed
Xu 2012 {published data only}
    1. Xu K, He L, Mai J, Yan X, Chen Y. Muscle recruitment and coordination following constraint‐induced movement therapy with electrical stimulation on children with hemiplegic cerebral palsy: a randomized controlled trial. PLOS One 2015;10(10):e0138608. [DOI: 10.1371/journal.pone.0138608; ChiCTR‐TRC‐13004041; PMC4599892; PUBMED: 26452230] - DOI - PMC - PubMed
    1. Xu K, Wang L, Mai J, He L. Efficacy of constraint‐induced movement therapy and electrical stimulation on hand function of children with hemiplegic cerebral palsy: a controlled clinical trial. Disability and Rehabilitation 2012;34(4):337‐46. [DOI: 10.3109/09638288.2011.607213; ChiCTR‐TRC‐13004041; PUBMED: 21961441] - DOI - PubMed
Yu 2012 {published data only (unpublished sought but not used)}
    1. Yu J, Kang H, Jung J. Effects of modified constraint‐induced movement therapy on hand dexterity, grip strength and activities of daily living of children with cerebral palsy: a randomized control trial. Journal of Physical Therapy Science 2012;24(10):1029‐31. [DOI: 10.1589/jpts.24.1029] - DOI
Zafer 2016 {published and unpublished data}
    1. Zafer H, Amjad I, Malik AN, Shaukat E. Effectiveness of constraint induced movement therapy as compared to bimanual therapy in upper motor function outcome in child with hemiplegic cerebral palsy. Pakistan Journal of Medical Sciences 2016;32(1):181‐4. [DOI: 10.12669/pjms.321.8491; PMC4795864; PUBMED: 27022371] - DOI - PMC - PubMed

References to studies excluded from this review

Andersen 2013 {published data only}
    1. Andersen JC, Majnemer A, O'Grady K, Gordon AM. Intensive upper extremity training for children with hemiplegia: from science to practice. Seminars in Pediatric Neurology 2013;20(2):100‐5. [DOI: 10.1016/j.spen.2013.06.001; PUBMED: 23948684 ] - DOI - PubMed
Ardakani 2010 {published data only}
    1. Ardakani MJN, Reza Olyaei G, Abdolvahab M, Bagheri H, Jalili M, Zadeh SF. The effects and maintenance of constraint‐induced therapy on spasticity and function of upper extremity in hemiplegic cerebral palsy children 6 to 12 years old. Journal of Modern Rehabilitation 2010;4(3‐4):41‐7. [mrj.tums.ac.ir/article‐1‐93‐en.html]
Aschner 2012 {published data only}
    1. Aschner A. Impact of Constraint‐Induced Movement Therapy on Brain Functioning in Children with Cerebral Palsy [Thesis]. Nashville (TN): Vanderbilt University, 2012. [discoverarchive.vanderbilt.edu/handle/1803/5060]
Ballaz 2012 {published data only}
    1. Ballaz L, Huffenus A‐F, Lamarre C, Koclas L, Lemay M. Effect of forced use therapy on posture in children with hemiplegic cerebral palsy: a pilot study. Journal of Rehabilitation Medicine 2012;44(3):268‐71. [DOI: 10.2340/16501977-0920; PUBMED: 22278090] - DOI - PubMed
Basu 2012a {published data only}
    1. Basu A, Eyre JA. A plea for consideration of the less affected hand in therapeutic approaches to hemiplegia. Developmental Medicine & Child Neurology 2012;54(4):380‐2. [DOI: 10.1111/j.1469-8749.2012.04242.x; PUBMED: 22348374] - DOI - PubMed
Bonnier 2006 {published data only}
    1. Bonnier B, Eliasson A‐C, Krumlinde‐Sundholm L. Effects of constraint‐induced movement therapy in adolescents with hemiplegic cerebral palsy: a day camp model. Scandanavian Journal of Occupational Therapy 2006;13(1):13‐22. [PUBMED: 16615411] - PubMed
Boyd 2001 {published data only}
    1. Boyd RN, Morris ME, Graham HK. Management of upper limb dysfunction in children with cerebral palsy: a systematic review. European Journal of Neurology 2001;8(Suppl. 5):150‐66. [DOI: 10.1046/j.1468-1331.2001.00048.x; PUBMED: 11851744] - DOI - PubMed
Brady 2009 {published data only}
    1. Brady K, Garcia T. Constraint‐induced movement therapy (CIMT): pediatric applications. Developmental Disabilities Research Reviews 2009;15(2):102‐11. [DOI: 10.1002/ddrr.59; 19489088] - DOI - PubMed
Brandão 2009 {published data only}
    1. Brandão MB, Mancini MC, Vaz DV, Bueno AM, Furtado SR, Coelho ZA. Effects of constraint‐induced movement therapy in children with hemiplegia: a single case experimental study. Revista Brasileira de Fisioterapia 2009;13(6):527‐34. [DOI: 10.1590/S1413-35552009005000064] - DOI
Brekke 2004 {published data only}
    1. Brekke EL, Ehler LA, Furze JA, Goulet C. Constraint induced therapy for a child with cerebral palsy: a case study. Pediatric Physical Therapy 2004;16(1):71. [DOI: 10.1097/01.PEP.0000115223.79541.5C] - DOI
Buesch 2010 {published data only}
    1. Buesch FE, Schlaepfer B, Bruin ED, Wohlrab G, Ammann‐Reiffer C, Meyer‐Heim A. Constraint‐induced movement therapy for children with obstetric brachial plexus palsy: two single‐case series. International Journal of Rehabilitation Research 2010;33(2):187‐92. [DOI: 10.1097/MRR.0b013e3283310d6e; PUBMED: 19738482] - DOI - PubMed
Cao 2015 {published data only}
    1. Cao J, Khan B, Hervey N, Tian F, Delgado MR, Clegg NJ, et al. Evaluation of cortical plasticity in children with cerebral palsy undergoing constraint‐induced movement therapy based on functional near‐infrared spectroscopy. Journal of Biomedical Optics 2015;20(4):046009. [DOI: 10.1117/1.JBO.20.4.046009; PMC4479242; PUBMED: 25900145] - DOI - PMC - PubMed
Charles 2001 {published data only}
    1. Charles J, Lavinder G, Gordon AM. Effects of constraint‐induced therapy on hand function in children with hemiplegic cerebral palsy. Pediatric Physical Therapy 2001;13(2):68‐76. [PUBMED: 17053660] - PubMed
Charles 2005 {published data only}
    1. Charles J, Gordon AM. A critical review of constraint‐induced movement therapy and forced use in children with hemiplegia. Neural Plasticity 2005;12(2‐3):245‐61. [DOI: 10.1155/NP.2005.245; PMC2565448; PUBMED: 16097492] - DOI - PMC - PubMed
Chen 2014a {published data only}
    1. Chen Y‐P, Pope S, Tyler D, Warren GL. Effectiveness of constraint‐induced movement therapy on upper‐extremity function in children with cerebral palsy: a systematic review and meta‐analysis of randomized controlled trials. Clinical Rehabilitation 2014;28(10):939‐53. [DOI: 10.1177/0269215514544982; PUBMED: 25125440] - DOI - PubMed
Chevignard 2008 {published data only}
    1. Chevignard M, Azzi V, Abada G, Lemesle C, Bur S, Toure H, et al. The effectiveness of constraint‐induced movement therapy for children with hemiplegia following acquired brain injury [Intérêt de la thérapie par contrainte induite chez l’enfant hémiplégique après lésion cérébrale acquise]. Annales de Réadaptation et de Médecine Physique 2008;51(4):238–47. [DOI: 10.1016/j.annrmp.2008.01.013; PUBMED: 18395284 ] - DOI - PubMed
Cheyne 2013 {published data only}
    1. Cheyne DO, Fehlings D. Can neuroimaging help identify effective strategies for constraint therapy in congenital hemiparesis?. Developmental Medicine & Child Neurology 2013;55(10):882‐3. [DOI: 10.1111/dmcn.12238; PUBMED: 23937171 ] - DOI - PubMed
Chiu 2016 {published data only}
    1. Chiu H‐C, Ada L. Constraint‐induced movement therapy improves upper limb activity and participation in hemiplegic cerebral palsy: a systematic review. Journal of Physiotherapy 2016;62(3):130‐7. [DOI: 10.1016/j.jphys.2016.05.013; PUBMED: 27323932 ] - DOI - PubMed
Christman 2015 {published data only}
    1. Christman E, McAllister K, Claar K, Kaufman S, Page SJ. Occupational therapists' opinions of two pediatric constraint‐induced movement therapy protocols. American Journal of Occupational Therapy 2015;69(6):6906180020. [DOI: 10.5014/ajot.2015.019042; PUBMED: 26565095 ] - DOI - PubMed
Cimolin 2012 {published data only}
    1. Cimolin V, Beretta E, Piccinini L, Turconi AC, Locatelli F, Galli M, et al. Constraint‐induced movement therapy for children with hemiplegia after traumatic brain injury: a quantitative study. Journal of Head Trauma Rehabilitation 2012;27(3):177‐87. [DOI: 10.1097/HTR.0b013e3182172276; PUBMED: 21522025 ] - DOI - PubMed
Cohen‐Holzer 2010 {published data only}
    1. Cohen‐Holzer M, Reinstein R, Rotem H, Katz‐Leurer M. The effect of combined training‐constraint and bimanual use on hand function of children with cerebral palsy hemiparesis. Developmental Medicine & Child Neurology 2010;52(Suppl 5):28. [DOI: 10.1111/j.1469-8749.2010.03755.x; E6] - DOI
Cohen‐Holzer 2011 {published data only}
    1. Cohen‐Holzer M, Katz‐Leurer M, Reinstein R, Rotem H, Meyer S. The effect of combining daily restraint with bimanual intensive therapy in children with hemiparetic cerebral palsy: a self‐control study. NeuroRehabilitation 2011;29(1):29‐36. [DOI: 10.3233/NRE-2011-0674; PUBMED: 21876293] - DOI - PubMed
Cohen‐Holzer 2016 {published data only}
    1. Cohen‐Holzer M, Sorek G, Schless S, Kerem J, Katz‐Leurer M. The influence of a constraint and bimanual training program using a variety of modalities, on upper extremity functions and gait parameters among children with hemiparetic cerebral palsy: a case series. Physical & Occupational Therapy in Pediatrics 2016;36(1):17‐27. [DOI: 10.3109/01942638.2014.990549; PUBMED: 25521486] - DOI - PubMed
Coker 2009 {published data only}
    1. Coker P, Lebkicher C, Harris L, Snape J. The effects of constraint‐induced movement therapy for a child less than one year of age. NeuroRehabilitation 2009;24(3):199‐208. [DOI: 10.3233/NRE-2009-0469; PUBMED: 19458426] - DOI - PubMed
Coker 2010 {published data only}
    1. Coker P, Karakostas T, Dodds C, Hsiang S. Gait characteristics of children with hemiplegic cerebral palsy before and after modified constraint‐induced movement therapy. Disability and Rehabilitation 2010;32(5):402‐8. [DOI: 10.3109/09638280903171592; PUBMED: 20095954 ] - DOI - PubMed
Cope 2008 {published data only}
    1. Cope SM, Forst HC, Bibis D, Liu X‐C. Modified constraint‐induced movement therapy for a 12‐month‐old child with hemiplegia: a case report. American Journal of Occupational Therapy 2008;62(4):430‐7. [DOI: 10.5014/ajot.62.4.430; PUBMED: 18712005] - DOI - PubMed
Cope 2010 {published data only}
    1. Cope SM, Liu X‐C, Verber MD, Cayo C, Rao S, Tassone JC. Upper limb function and brain reorganization after constraint‐induced movement therapy in children with hemiplegia. Developmental Neurorehabilitation 2010;13(1):19‐30. [DOI: 10.3109/17518420903236247; PUBMED: 20067342] - DOI - PubMed
Crocker 1997 {published data only}
    1. Crocker MD, MacKay‐Lyons M, McDonnell E. Forced use of the upper extremity in cerebral palsy: a single case study design. American Journal of Occupational Therapy 1997;51(10):824‐33. [DOI: 10.5014/ajot.51.10.824; PUBMED: 9394143] - DOI - PubMed
DeLuca 2003 {published data only}
    1. DeLuca SC, Echols K, Ramey SL, Taub E. Pediatric constraint‐induced movement therapy for a young child with cerebral palsy: two episodes care. Physical Therapy 2003;83(11):1003‐13. [PUBMED: 14577827] - PubMed
DeLuca 2015 {published data only}
    1. DeLuca SC, Ramey SL, Trucks MR, Wallace DA. Multiple treatments of pediatric constraint‐induced movement therapy (pCIMT): a clinical cohort study. American Journal of Occupational Therapy 2015;69(6):6906180010. [DOI: 10.5014/ajot.2015.019323; PMC4643376; PUBMED: 26565094] - DOI - PMC - PubMed
Dickerson 2007 {published data only}
    1. Dickerson AE, Brown LE. Pediatric constraint‐induced movement therapy in a young child with minimal active arm movement. American Journal of Occupational Therapy 2007;61(5):563‐73. [PUBMED: 17944294] - PubMed
Dong 2013 {published data only}
    1. Dong VA‐Q, Tung IH‐H, Siu HW‐Y, Fong KN‐K. Studies comparing the efficacy of constraint‐induced movement therapy and bimanual training in children with unilateral cerebral palsy: a systematic review. Developmental Neurorehabilitation 2013;16(2):133‐43. [DOI: 10.3109/17518423.2012.702136; PUBMED: 22946588] - DOI - PubMed
Echols 2000 {published data only}
    1. Echols K, DeLuca SC, Taub E, Ramey S. Constraint‐induced movement therapy in young children: a protocol and outcomes compared to traditional measures. Pediatric Physical Therapy 2000;12(4):210. [12]
Eliasson 2003 {published data only}
    1. Eliasson A‐C, Bonnier B, Krumlinde‐Sundholm L. Clinical experience of constraint induced movement therapy in small children with hemiplegic cerebral palsy ‐‐ a day camp model. Developmental Medicine & Child Neurology 2003;45(5):357‐9. [PUBMED: 12729152] - PubMed
Eliasson 2005 {published and unpublished data}
    1. Eliasson A‐C, Krumlinde‐Sundholm L, Shaw K, Wang C. Effects of constraint‐induced movement therapy in young children with hemiplegic cerebral palsy: an adapted model. Developmental Medicine & Child Neurology 2005;47(4):266‐75. [PUBMED: 15832550] - PubMed
Eliasson 2009 {published data only}
    1. Eliasson A‐C, Shaw K, Pontén E, Boyd RN, Krumlinde‐Sundholm L. Feasibility of a day‐camp model of modified constraint‐induced movement therapy with and without botulinum toxin A injection for children with hemiplegia. Physical & Occupational Therapy in Pediatrics 2009;29(3):311‐33. [PUBMED: 19842858] - PubMed
Eliasson 2014a {published data only}
    1. Eliasson A‐C, Krumlinde‐Sundholm L, Gordon AM, Feys H, Klingels K, Aarts PB, et al. Guidelines for future research in constraint‐induced movement therapy for children with unilateral cerebral palsy: an expert consensus. Developmental Medicine & Child Neurology 2014;56(2):125‐37. [DOI: 10.1111/dmcn.12273; PUBMED: 24266735] - DOI - PubMed
Eliasson 2015 {published data only}
    1. Eliasson A‐C. What can be learned from reporting no‐treatment effect of distribution of upper limb training?. Developmental Medicine & Child Neurology 2015;57(6):498. [DOI: 10.1111/dmcn.12706] - DOI - PubMed
Fergus 2008 {published data only}
    1. Fergus A, Buckler J, Farrell J, Isley M, McFarland M, Riley B. Constraint‐induced movement therapy for a child with hemiparesis: a case report. Pediatric Physical Therapy 2008;20(3):271‐83. [DOI: 10.1097/PEP.0b013e318181e569; PUBMED: 18703966] - DOI - PubMed
Fetters 2004 {published data only}
    1. Fetters L, Figueiedo EM, Keane‐Miller D, McSweeney DJ, Tsao C‐C. Critically appraised topics 67. Is constraint‐induced therapy an effective intervention for the treatment of upper extremity dysfunction in children with spastic hemiplegic cerebral palsy (CP)?. Pediatric Physical Therapy 2004;16(1):77‐9. [DOI: 10.1097/01.PEP.0000116783.25230.8C] - DOI - PubMed
Ganapathy Sankar 2015 {published data only}
    1. Ganapathy Sankar U. Constraint induced movement therapy (CIMT) for children with hemiplegic cerebral palsy to improve upper extremity function: pilot study. International Journal of Science and Research 2015;4(5):2524‐7. [Paper ID: SUB154817; www.ijsr.net/archive/v4i5/SUB154817.pdf]
Geerdink 2015 {published data only}
    1. Geerdink YA, Aarts P, Burg J, Steenbergen B, Geurts A. Intensive upper limb intervention with self‐management training is feasible and promising for older children and adolescents with unilateral cerebral palsy. Research in Developmental Disabilities 2015;43‐44:97‐105. [DOI: 10.1016/j.ridd.2015.06.013; PUBMED: 26164301] - DOI - PubMed
Gillick 2010 {published data only}
    1. Gillick BT, Koppes A. Gross motor outcomes in children with hemiparesis involved in a modified constraint‐induced therapy program. Journal of Pediatric Rehabilitation Medicine 2010;3(3):171‐5. [DOI: 10.3233/PRM-2010-0126; PUBMED: 21791848] - DOI - PubMed
Gillick 2014 {published data only}
    1. Gillick B, Krach LE, Feyma T, Rich TL, Moberg K, Thomas W, et al. Primed low‐frequency repetitive transcranial magnetic stimulation and constraint‐induced movement therapy in pediatric hemiparesis: a randomized controlled trial. Developmental Medicine & Child Neurology 2014;56(1):44‐52. [DOI: 10.1111/dmcn.12243; NCT01104064; PMC3864983; PUBMED: 23962321] - DOI - PMC - PubMed
Gillick 2015 {published data only}
    1. Gillick BT, Krach LE, Feyma T, Rich TL, Moberg K, Menk J, et al. Safety of primed repetitive transcranial magnetic stimulation and modified constraint‐induced movement therapy in a randomized controlled trial in pediatric hemiparesis. Archives of Physical Medicine and Rehabilitation 2015;96(Suppl 4):S104‐13. [DOI: 10.1016/j.apmr.2014.09.012; NCT01104064; PMC4380609; PUBMED: 25283350] - DOI - PMC - PubMed
Gillick 2018 {published data only}
    1. Gillick B, Rich T, Nemanich S, Chen C‐Y, Menk J, Mueller B, et al. Transcranial direct current stimulation and constraint‐induced therapy in cerebral palsy: a randomized, blinded, sham‐controlled clinical trial. European Journal of Paediatric Neurology 2018;22(3):358‐68. [DOI: 10.1016/j.ejpn.2018.02.001; NCT 02250092; PMC5899638; PUBMED: 29456128] - DOI - PMC - PubMed
Glover 2002 {published data only}
    1. Glover JE, Matter CA, Yoell C, Speed S. The effectiveness of constraint induced movement therapy in two young children with hemiplegia. Pediatric Rehabilitation 2002;5(3):125‐31. [DOI: 10.1080/1363849021000039326; PUBMED: 12581474] - DOI - PubMed
Gordon 2001 {published data only}
    1. Gordon AM. Constraint‐induced therapy in children with hemiplegic cerebral palsy. Developmental Medicine and Child Neurology 2001;43(Suppl 87):6‐7. [DOI: 10.1111/j.1469-8749.2001.tb04119.x] - DOI - PubMed
Gordon 2005 {published data only}
    1. Gordon AM, Charles J, Wolf SL. Methods of constraint induced movement therapy for children with hemiplegic cerebral palsy: development of a child‐friendly intervention for improving upper‐extremity function. Archives of Physical Medicine and Rehabilitation 2005;86(4):837‐44. [DOI: 10.1016/j.apmr.2004.10.008; PUBMED: 15827942] - DOI - PubMed
Gordon 2006 {published data only}
    1. Gordon AM, Charles J, Wolf SL. Efficacy of constraint‐induced movement therapy on involved upper‐extremity use in children with hemiplegic cerebral palsy is not age‐dependent. Pediatrics 2006;117(3):e363‐73. [DOI: 10.1542/peds.2005-1009; PUBMED: 16510616] - DOI - PubMed
Gordon 2007 {published data only}
    1. Gordon A, Connelly A, Neville B, Vargha‐Khadem F, Jessop N, Murphy T, et al. Modified constraint‐induced movement therapy after childhood stroke. Developmental Medicine & Child Neurology 2007;49(1):23‐7. [DOI: 10.1111/j.1469-8749.2007.0072a.x; PUBMED: 17209972] - DOI - PubMed
Gordon 2008 {published data only}
    1. Gordon AM, Chinnan A, Gill S, Petra E, Hung YC, Charles J. Both constraint‐induced movement therapy and bimanual training lead to improved performance of upper extremity function in children with hemiplegia. Developmental Medicine & Child Neurology 2008;50(12):957‐8. [PUBMED: 19160464] - PubMed
Gordon 2010 {published data only}
    1. Gordon AM, Okita SY. Augmenting pediatric constraint‐induced movement therapy and bimanual training with video gaming technology. Technology and Disability 2010;22(4):179‐91. [DOI: 10.3233/TAD-2010-0302] - DOI
Gordon 2011a {published data only}
    1. Gordon AM. To constrain or not to constrain, and other stories of intensive upper extremity training for children with unilateral cerebral palsy. Developmental Medicine & Child Neurology 2011;53 Suppl 4:56‐61. [DOI: 10.1111/j.1469-8749.2011.04066.x; PUBMED: 21950396] - DOI - PubMed
Gordon 2011b {published data only}
    1. Gordon AM. Is it time to remove the restraints?. Developmental Medicine & Child Neurology 2011;53(4):292‐3. [DOI: 10.1111/j.1469-8749.2010.03906.x; PUBMED: 21401580] - DOI - PubMed
Hackman 2000 {published data only}
    1. Hackman FC, Kauffman KD. Home implementation of constraint induced movement therapy in a child with hemiplegia: a comparison of impact on child and family life to gross and fine motor functional gains. Pediatric Physical Therapy 2000;12(4):214. [21]
Hart 2005 {published data only}
    1. Hart H. Can constraint therapy be developmentally appropriate and child friendly?. Developmental Medicine & Child Neurology 2005;47(6):363. [DOI: 10.1017/S0012162205000708; onlinelibrary.wiley.com/doi/pdf/10.1111/j.1469‐8749.2005.tb01152.x] - DOI - PubMed
Haynes 2012 {published data only}
    1. Haynes MP, Phillips D. Modified constraint induced movement therapy enhanced by a neuro‐development treatment‐based therapeutic handling protocol: two case studies. Journal of Pediatric Rehabilitation Medicine 2012;5(2):117‐24. [DOI: 10.3233/PRM-2012-0203; PUBMED: 22699102] - DOI - PubMed
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Hoare 2014 {published data only}
    1. Hoare BJ. Putting some excitement into constraint‐induced movement therapy. Developmental Medicine & Child Neurology 2014;56(1):5‐6. [DOI: 10.1111/dmcn.12272; PUBMED: 23980669] - DOI - PubMed
Hoare 2015 {published data only}
    1. Hoare BJ. Constraint therapy, the panacea for unilateral cerebral palsy?. Developmental Medicine & Child Neurology 2015;57(1):12‐3. [DOI: 10.1111/dmcn.12596; PUBMED: 25315321] - DOI - PubMed
Huang 2009 {published data only}
    1. Huang H‐H, Fetters L, Hale J, McBride A. Bound for success: a systematic review of constraint‐induced movement therapy in children with cerebral palsy supports improved arm and hand use. Physical Therapy 2009;89(11):1126‐41. [DOI: 10.2522/ptj.20080111; PUBMED: 19729391] - DOI - PubMed
Huang 2010 {published data only}
    1. Huang W‐C, Chen Y‐J, Chien C‐L, Kashima H, Lin K‐C. Constraint‐induced movement therapy as a paradigm of translational research in neurorehabilitation: reviews and prospects. American Journal of Translational Research 2010;3(1):48‐60. [PMC2981425; PUBMED: 21139805] - PMC - PubMed
Islam 2014 {published data only}
    1. Islam M, Nordstrand L, Holmström L, Kits A, Forssberg H, Eliasson A‐C. Is outcome of constraint‐induced movement therapy in unilateral cerebral palsy dependent on corticomotor projection pattern and brain lesion characteristics?. Developmental Medicine & Child Neurology 2014;56(3):252‐8. [DOI: 10.1111/dmcn.12353; PUBMED: 24341408] - DOI - PubMed
Juenger 2007 {published data only}
    1. Juenger H, Linder‐Lucht M, Walther M, Berweck S, Mall V, Staudt M. Cortical neuromodulation by constraint‐induced movement therapy in congenital hemiparesis: an FMRI study. Neuropediatrics 2007;38(3):130‐6. [DOI: 10.1055/s-2007-985904; PUBMED: 17985262] - DOI - PubMed
Juenger 2013 {published data only}
    1. Juenger H, Kuhnke N, Braun C, Ummenhofer F, Wilke M, Walther M, et al. Two types of exercise‐induced neuroplasticity in congenital hemiparesis: a transcranial magnetic stimulation, functional MRI, and magnetoencephalography study. Developmental Medicine & Child Neurology 2013;55(10):941‐51. [DOI: 10.1111/dmcn.12209; PUBMED: 23937719] - DOI - PubMed
Karman 2003 {published data only}
    1. Karman N, Maryles J, Baker RW, Simpser E, Berger‐Gross P. Constraint‐induced movement therapy for hemiplegic children with acquired brain injuries. Journal of Head Trauma Rehabilitation 2003;18(3):259‐67. [PUBMED: 12802168] - PubMed
Kim 2015a {published data only}
    1. Kim G, Blitz J. Commentary on “Constraint‐induced movement therapy in children aged 5 to 9 years with cerebral palsy: a day camp model". Pediatric Physical Therapy 2015;27(1):81. [DOI: 10.1097/PEP.0000000000000113; PUBMED: 25521269] - DOI - PubMed
Klepper 2017 {published data only}
    1. Klepper SE, Clayton Krasinski D, Gilb MC, Khalil N. Comparing unimanual and bimanual training in upper extremity function in children with unilateral cerebral palsy. Pediatric Physical Therapy 2017;29(4):288‐306. [DOI: 10.1097/PEP.0000000000000438; PUBMED: 28953170] - DOI - PubMed
Klingels 2013 {published and unpublished data}
    1. Klingels K, Feys H, Molenaers G, Verbeke G, Daele S, Hoskens J, et al. Randomized trial of modified constraint‐induced movement therapy with and without an intensive therapy program in children with unilateral cerebral palsy. Neurorehabilitation and Neural Repair 2013;27(9):799‐807. [DOI: 10.1177/1545968313496322; PUBMED: 23901061] - DOI - PubMed
Kong 2013 {published data only}
    1. Kong E‐J, Chun K‐A, Jeong J‐H, Cho I‐H. Brain SPECT analysis after constraint‐induced movement therapy in young children with hemiplegic cerebral palsy: case report. Nuclear Medicine and Molecular Imaging 2013;47(2):119‐24. [DOI: 10.1007/s13139-013-0200-1; PMC4041966; PUBMED: 24900092] - DOI - PMC - PubMed
Kuhnke 2008 {published data only}
    1. Kuhnke N, Juenger H, Walther M, Berweck S, Mall V, Staudt M. Do patients with congenital hemiparesis and ipsilateral corticospinal projections respond differently to constraint‐induced movement therapy?. Developmental Medicine & Child Neurology 2008;50(12):898‐903. [DOI: 10.1111/j.1469-8749.2008.03119.x; PUBMED: 18811703] - DOI - PubMed
Kwon 2014 {published data only}
    1. Kwon J‐Y, Chang WH, Chang HJ, Yi S‐H, Kim M‐Y, Kim E‐H, et al. Changes in diffusion tensor tractographic findings associated with constraint‐induced movement therapy in young children with cerebral palsy. Clinical Neurophysiology 2014;125(12):2397‐403. [DOI: 10.1016/j.clinph.2014.02.025; PUBMED: 24746686] - DOI - PubMed
Lavinder 2007 {published data only}
    1. Lavinder G. Constraint‐Induced Therapy in the Upper Extremity for Children with Hemiplegic Cerebral Palsy [PhD thesis]. New York (NY): Teachers College, Columbia University, 2007.
Lee 2010 {published data only}
    1. Lee Z. Effects of constraint‐induced movement therapy on cortical reorganization in patients with hemiplegic cerebral palsy. Developmental Medicine & Child Neurology 2010;52(Suppl 4):37‐8. [DOI: 10.1111/j.1469-8749.2010.03682.x; PP 8.13] - DOI
Leon‐Santos 2008 {published data only}
    1. León‐Santos MR, Romero‐Torres MD, Conjero‐Casares JA. Efficacy of constraint‐induced movement therapy in children with cerebral palsy [Eficacia de la terapia de movimiento inducido por restricción en niños con parálisis cerebral]. Rehabilitación 2008;42(4):199‐204. [DOI: 10.1016/S0048-7120(08)74587-0; medes.com/publication/42602] - DOI
Lin 2011 {published data only}
    1. Lin K‐C, Wang T‐N, Wu C‐Y, Chen C‐l, Chang K‐C, Lin Y‐C, et al. Effects of home‐based constraint‐induced therapy versus dose‐matched control intervention on functional outcomes and caregiver well‐being in children with cerebral palsy. Research in Developmental Disabilities 2011;32(5):1483‐91. [DOI: 10.1016/j.ridd.2011.01.023; PUBMED: 21429706] - DOI - PubMed
Lowes 2014a {published data only}
    1. Lowes LP, Mayhan M, Orr T, Batterson N, Tonneman JA, Meyer A, et al. Pilot study of the efficacy of constraint‐induced movement therapy for infants and toddlers with cerebral palsy. Physical & Occupational Therapy in Pediatrics 2014;34(1):4‐21. [DOI: 10.3109/01942638.2013.810186; PMC4162395; PUBMED: 23848499] - DOI - PMC - PubMed
Lowes 2014b {published data only}
    1. Lowes LP, Lo WD, Alfano LN, Case‐Smith J. Authors' response to evidence to practice commentary. Physical & Occupational Therapy in Pediatrics 2014;34(1):25‐9. [DOI: 10.3109/01942638.2014.880260; PUBMED: 24460081] - DOI - PubMed
Maitre 2011 {published data only}
    1. Maitre N, Henderson G, Gogliotti S, Simmons A, Key A. Constraint‐induced movement therapy improves neural processing efficiency and neurobehavioral function in children with hemiparetic cerebral palsy. Developmental Medicine & Child Neurology 2011;53(Suppl 5):27. [DOI: 10.1111/j.1469-8749.2011.04112.x; E2] - DOI
Manning 2014 {published data only}
    1. Manning KY. Resting State Functional Magnetic Resonance and Diffusion Tensor Imaging of Hemiplegic Cerebral Palsy Patients Treated with Constraint‐Induced Movement Therapy: Predictors and Clinically Correlated Evidence of Neuroplasticity [Masters thesis]. London (ON): The University of Western Ontario, 2014.
Manning 2015 {published data only}
    1. Manning KY, Fehlings D, Mesterman R, Gorter JW, Switzer L, Campbell C, et al. Resting state and diffusion neuroimaging predictors of clinical improvements following constraint‐induced movement therapy in children with hemiplegic cerebral palsy. Journal of Child Neurology 2015;30(11):1507‐14. [DOI: 10.1177/0883073815572686] - DOI - PubMed
Manning 2016 {published data only}
    1. Manning KY, Menon RS, Gorter JW, Mesterman R, Campbell C, Switzer L, et al. Neuroplastic sensorimotor resting state network reorganisation in children with hemiplegic cerebral palsy treated with constraint induced movement therapy. Journal of Child Neurology 2016;31(2):220‐6. [DOI: 10.1177/0883073815588995; PUBMED: 26078420] - DOI - PubMed
Martin 2008 {published data only}
    1. Martin A, Burtner PA, Poole J, Philips J. Case report: ICF‐level changes in a preschooler after constraint‐induced movement therapy. American Journal of Occupational Therapy 2008;62(3):282‐8. [PUBMED: 18557004] - PubMed
Mcconnell 2014 {published data only}
    1. McConnell K, Johnston L, Kerr C. Efficacy and acceptability of reduced intensity constraint‐induced movement therapy for children aged 9‐11 years with hemiplegic cerebral palsy: a pilot study. Physical & Occupational Therapy in Pediatrics 2014;34(3):245‐59. [DOI: 10.3109/01942638.2013.866611; PUBMED: 24341455] - DOI - PubMed
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    1. Motta F, Antonello CE, Stignani C. Forced‐use, without therapy, in children with hemiplegia: preliminary study of a new approach for the upper limb. Journal of Pediatric Orthopedics 2010;30(6):582‐7. [DOI: 10.1097/BPO.0b013e3181e88ee4; PUBMED: 20733424] - DOI - PubMed
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    1. Nascimento LR, Glória AE, Habib ES. Effects of constraint‐induced movement therapy as a rehabilitation strategy for the affected upper limb of children with hemiparesis: systematic review of the literature [Efeitos da terapia de movimento induzido por restrição como estratégia de reabilitação do membro superior acometido de crianças hemiparéticas: revisão sistemática da literatura]. Revista Brasieria de Fisioterapia 2009;13(2):97‐102. [DOI: 10.1590/S1413-35552009005000022; pdfs.semanticscholar.org/a5c1/7666ffe113011efa630f58629ea7da92a344.pdf] - DOI
Naylor 2005 {published data only}
    1. Naylor CE, Bower E. Modified constraint‐induced movement therapy for young children with hemiplegic cerebral palsy: a pilot study. Developmental Medicine & Child Neurology 2005;47(6):365–9. [DOI: 10.1111/j.1469-8749.2005.tb01155.x; PUBMED: 15934484] - DOI - PubMed
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    1. NCT02957708. Constraint‐induced movement therapy and self‐regulation for children with cerebral palsy [Effectiveness of modified constraint‐induced movement therapy and self‐regulation learning for children with hemiplegic cerebral palsy]. clinicaltrials.gov/ct2/show/NCT02957708 (first received 22 September 2016). [NCT02957708]
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Nordstrand 2013 {published data only}
    1. Nordstrand L, Eliasson A‐C. Six years after a modified constraint induced movement therapy (CIMT) program ‐‐ what happens when the children have become young adults?. Physical & Occupational Therapy in Pediatrics 2013;33(2):163‐9. [DOI: 10.3109/01942638.2013.757157; PUBMED: 23369068] - DOI - PubMed
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Pardeep 2010 {unpublished data only}
    1. Pardeep M, Senthilkumar CB, Mamta S. Efficacy of modified constraint‐induced movement therapy in children with spastic hemiparetic cerebral palsy. Indian Journal of Physiotherapy and Occupational Therapy 2010;4(1):47‐53. [www.indianjournals.com/ijor.aspx?target=ijor:ijpot&volume=4&issu...
Park 2009 {published data only}
    1. Park ES, Rha D‐W, Lee JD, Yoo JK, Chang WH. The short‐term effects of combined modified constraint‐induced movement therapy and botulinum toxin injection for children with spastic hemiplegic cerebral palsy. Neuropediatrics 2009;40(6):269‐74. [DOI: 10.1055/s-0030-1252049; PUBMED: 20446220] - DOI - PubMed
Pidcock 2009 {published data only}
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Pierce 2002 {published data only}
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Psychouli 2010 {published data only}
    1. Psychouli P, Burridge J, Kennedy C. Forced use as a home‐based intervention in children with congenital hemiplegic cerebral palsy: choosing the appropriate constraint. Disability and Rehabilitation: Assistive Technology 2010;5(1):25‐33. [DOI: 10.3109/17483100903121489; PUBMED: 19941438] - DOI - PubMed
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    1. Psychouli P, Kennedy CR. Modified constraint‐induced movement therapy as a home‐based intervention for children with cerebral palsy. Pediatric Physical Therapy 2016;28(2):154‐60. [DOI: 10.1097/PEP.0000000000000227; PUBMED: 26808960] - DOI - PubMed
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    1. Ramey SL, DeLuca SC, Case‐Smith J, Stevenson R. Caution is warranted in interpreting data from a recent trial of modified constraint‐induced therapy. Developmental Medicine & Child Neurology 2012;54(5):477‐9; author reply 479‐81. [DOI: 10.1111/j.1469-8749.2012.04240.x; PUBMED: 22409421] - DOI - PubMed
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Reidy 2018 {published data only}
    1. Reidy TG, Carney J, Schoenbrodt L, Pidcock FS. Reporting collateral effects of pediatric constraint induced movement therapy: parent observed speech and language changes. Journal of Interprofessional Education and Practice 2018;11:58‐63. [10.1016/j.xjep.2018.02.006]
Rickards 2014 {published data only}
    1. Rickards T, Sterling C, Taub E, Perkins‐Hu C, Gauthier L, Graham M, et al. Diffusion tensor imaging study of the response to constraint‐induced movement therapy of children with hemiparetic cerebral palsy and adults with chronic stroke. Archives of Physical Medicine and Rehabilitation 2014;95(3):506‐14.e1. [DOI: 10.1016/j.apmr.2013.08.245; PUBMED: 24055785] - DOI - PubMed
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    1. Ries JD, Leonard R. Is there evidence to support the use of constraint‐induced therapy to improve the quality or quantity of upper extremity function of a 2 ½‐year‐old girl with congenital hemiparesis? If so, what are the optimal parameters of this intervention?. Physical Therapy 2006;86(5):746‐52. [DOI: 10.1093/ptj/86.5.746] - DOI - PubMed
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    1. Roberts H. Constraint Induced Movement Therapy with Armeo® Spring Pediatric Training for Children with Hemiplegic Cerebral Palsy: A Comparative Study [PhD thesis]. Denton (TX): Texas Woman’s University, 2015.
Rocca 2013 {published data only}
    1. Rocca MA, Turconi AC, Strazzer S, Absinta M, Valsasina P, Beretta E, et al. MRI predicts efficacy of constraint‐induced movement therapy in children with brain injury. Neurotherapeutics 2013;10(3):511‐9. [DOI: 10.1007/s13311-013-0189-2; PMC3701764; PUBMED: 23605556] - DOI - PMC - PubMed
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Sakzewski 2012 {published data only}
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Sakzewski 2014 {published data only}
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Schrank 2013 {published data only}
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Seema 2015 {published data only}
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Shetty 2014 {published data only}
    1. Shetty R, Joshi A, Shibila J. The Magical Pouch Program: a case study of modified constraint induced movement therapy with bimanual training on a child with unilateral spastic cerebral palsy. Indian Journal of Occupational Therapy 2014;46(1):3‐9. [medind.nic.in/iba/t14/i1/ibat14i1p3.pdf]
Staudt 2014 {published data only}
    1. Staudt M, Berweck S. Is constraint‐induced movement therapy harmful in unilateral spastic cerebral palsy with ipsilateral cortico‐spinal projections?. Developmental Medicine & Child Neurology 2014;56(3):202‐3. [DOI: 10.1111/dmcn.12372; PUBMED: 24372093] - DOI - PubMed
Stearns 2009 {published data only}
    1. Stearns GE, Burtner PA, Keenan KM, Qualls C, Phillips J. Effects of constraint‐induced movement therapy on hand skills and muscle recruitment of children with spastic hemiplegic cerebral palsy. NeuroRehabilitation 2009;24(2):95‐108. [DOI: 10.3233/NRE-2009-0459; PUBMED: 19339749] - DOI - PubMed
Sterling 2013 {published data only}
    1. Sterling C, Taub E, Davis D, Rickards T, Gauthier LV, Griffin A, et al. Structural neuroplastic change after constraint‐induced movement therapy in children with cerebral palsy. Pediatrics 2013;131(5):e1664‐9. [DOI: 10.1542/peds.2012-2051; PUBMED: 23610209] - DOI - PubMed
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Tervahauta 2017 {published data only}
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Thakkar 2014 {published data only}
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    1. Wallen M, Hoare B. There is weak evidence that forced‐use therapy provided for 1‐month without additional therapy improved the fine motor function of children with hemiparesis. Australian Occupational Therapy Journal 2004;51(2):110‐1. [DOI: 10.1111/j.1440-1630.2004.00435.x] - DOI
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References to ongoing studies

Boyd 2017 {published data only}
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Chamudot 2016 {published data only}
    1. Chamudot R, Parush S, Gross‐Tsur V. Modified‐constraint induced movement therapy for infants with hemiplegia: a randomized trial. Developmental Medicine & Child Neurology 2016;58(Suppl 6):54‐5. [DOI: 10.1111/dmcn.13322; NCT01214902] - DOI
Chorna 2015 {published data only}
    1. Chorna O, Heathcock J, Key A, Noritz G, Carey H, Hamm E, et al. Early childhood constraint therapy for sensory/motor impairment in cerebral palsy: a randomised clinical trial protocol. BMJ Open 2015;5(12):e010212. [DOI: 10.1136/bmjopen-2015-010212; NCT02567630; PMC4679990; PUBMED: 26644127] - DOI - PMC - PubMed
NCT02346825 {published data only}
    1. NCT02346825. The Baby CHAMP Study (Children With Hemiparesis Arm and Movement Project) (The Baby CHAMP) [Multisite RCT of 3 neurorehabilitation therapies for infants with asymmetrical cerebral palsy]. clinicaltrials.gov/ct2/show/NCT02346825 (first received 15 January 2015). [NCT02346825]
NCT02808195 {published data only}
    1. NCT02808195. Comparative effectiveness of a Kinect‐based unilateral arm training system vs constraint‐induced therapy for children with cerebral palsy. clinicaltrials.gov/ct2/show/NCT02808195 (first received 24 May 2016). [NCT02808195]
NCT02840643 {published data only}
    1. NCT02840643. Combined constraint therapy and bimanual therapy for children with unilateral brain injury. clinicaltrials.gov/ct2/show/NCT02840643 (first received 19 July 2016). [NCT00119132]
NCT02875054 {published data only}
    1. NCT02875054. Camp High 5: evaluation of the effect on upper limb function. clinicaltrials.gov/ct2/show/NCT02875054 (first received 12 August 2016). [NCT02875054]
NCT02918890 {published data only}
    1. NCT02918890. Intensive unimanual (CIMT) and bimanual training (HABIT) in children with hemiplegia. clinicaltrials.gov/ct2/show/NCT02918890 (first received 27 September 2016). [NCT02918890]

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