Supervised V/s Unsupervised Constraint Induced Movement Therapy in Improving Upper Extremity Function in Spastic Hemiparetic Cerebral Palsy Children

Constraint Induced Movement Therapy has been found to be a promising treatment for substantially improving the use of extremities affected by neurologic injuries such as stroke and traumatic brain injury in adults. The purpose of this study was to determine the applicability of a child friendly form of CI Therapy on young children with cerebral palsy.

Thirty Children with hemiplegic Cerebral Palsy age 4–8 years received CI Therapy and completed evaluations. They were randomized to either Group A or Group B. In both the groups children wore mitt as restraint on their non-involved upper extremity and the involved upper extremity was engaged into play & functional activities for six hours per day for ten week days. In Group A all the activities done by children were under the supervision of therapist where as Group B was more of home based program although activities were therapist guided. Changes in upper extremity function were evaluated with Quality of Upper Extremity Skills Test. The evaluations took place at the onset of intervention and after completing two weeks of intervention.

Children in both the groups demonstrated significant improved functional efficiency of their involved upper extremity (p<0.05). However, children in Group A had improved significantly more than the children in Group B (p<0.05).

Results suggest that the CI Therapy can improve motoric function among children with hemiparesis and that this efficacy is more in a therapist supervised CIMT program.