Effects Of ConstraintInduced Movement Therapy AsA Rehabilitation Strategy For The Affected UpperLimb Of Children With Hemiplegic Cerebral Palsy:Systematic Review Of The Literature

Hand function impairment is the main disability among children with hemiplegic cerebral palsy. They start to perform most motor tasks exclusively with their unaffected upper limb, thereby causing a phenomenon described as developmental disregard. To minimize this phenomenon, constraintinduced movement therapy (CIMT) is emerging as a rehabilitation strategy for improving the functional use of the affected upper limb. The aim of this study was to conduct a systematic review of the literature on the effects of CIMT among children with hemiparetic cerebral palsy.

In this systematic review of the literature a search of Cocharane, APTA. Pub Medline, Science Direct data base was done to analyze the effects of CIMT on the functional performance of the affected upper limb among children with hemiparesis. Selection criteria: All randomized controlled trials, controlled clinical trials, case studies and pilot studies on CIMT, modified CIMT and Forced were selected. The review discusses how CIMT in adults is different from paediatric population, the different types of CIMT used in children, key features and variations in protocols currently in use with children, the different methods of constraint used in paediatric population, outcome measures used and the efficacy of CIMT. Results: There are 13 studies fulfilled the inclusion criteria, reported substantial gains in functional use of the hemiplegic upper limb following CIMT with children. However, there was considerable variation between the studies regarding of type of constraint used, intensity and duration of training, and outcome measures. Modified CIMT with reduced duration constraining and training is feasible for children. Conclusion: Although there is huge variation in protocols for administering CIMT it can be reasonably effective mode of training of upper limb in hemiplegic cerebral palsy.