Constraint-Induced Movement Therapy (CIMT) is now designated a highly
efficacious treatment for children with cerebral palsy, based on rigorous
clinical trials. Yet virtually no evidence confirms that these moderate to
large size effects can be replicated in clinical practice for a more
heterogeneous clinical population. Thus there is a need to collect and
report treatment outcome data based on actual clinical practice as a
critical next step for implementation.
METHODS:
This study presents results from a prospective study conducted on a
clinical cohort of 88 children, 18 months to 12 years old (M = 55 months, SD = 5
months), who received high-intensity CIMT known as ACQUIREc. The children
varied in severity and etiology of their hemiparesis and a subset was
diagnosed with asymmetric quadriparesis.
RESULTS:
Pre- to post-CIMT assessments confirmed highly significant and clinically
meaningful changes based on both parental report (Pediatric Motor Activity
Log, p< 0.0001) and standardized measures (The Assisting Hand Assessment,
p= 0.04).
CONCLUSIONS:
Clinical practice of high-intensity CIMT (120 hours in 4 weeks) with
full-time casting of the less-impaired upper extremity produced benefits of
comparable magnitude to those from rigorous randomized controlled trials
(RCTs). Therapists were highly trained and actively monitored. Children
across a wide range of etiologies and severity levels realized positive
outcomes.
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