Effectiveness of modified constraint induced movement therapy along with conventional physiotherapy on upper extremity function for children with hemiplegic type of cerebral palsy

Abstract

Introduction: From the last few years constraint induced movement therapy (CIMT), as an intervention, has received a great deal of attention for children with Hemiplegic cerebral palsy (CP). To date, evidence on this treatment has been very poor and limited so additional research required. For various reasons, traditional form of therapy was neither considered feasible nor do child and family friendly for that we had use a modified form of CIMT. Objective: To determine the effectiveness of modified CIMT on upper extremity function of hemiplegic CP children characterized by restraining the unaffected hand with short sling up to wrist. Methodology: 12 children (age: 2 to 8 years) from pediatric physiotherapy clinics from Savar, CRP with hemiplegic CP were included in the study. Modified constraint was applied to unaffected hand. The intervention was given for 3 hrs/day including 30 minutes of therapy time and home program which could split into different sessions of no less than 30 minutes duration for consecutive 2 weeks. Pre and Post outcome measure by using QUEST (Quality of upper extremity skill test) and PMAL (pediatric motor activity log) were taken. Result: Significant difference between Pre and Post values of all components of PMAL and QUEST (P<0.05) showing the effectiveness of MCIMT in improving upper extremity function and in ADL activities. Conclusion: MCIMT yields statistically as well as clinically significant improvements in both motor function and functional use of the affected upper extremity in children between the ages of 2 and 8 years with hemiplegic CP.