Constraint-induced movement therapy for a child with hemiparesis: a case report.
This case report describes the outcomes of a method of constraint-induced movement therapy (CIMT) incorporated into a home program using a minimally restrictive constraint over an 18-month period. The movement of the uninvolved hand and wrist of a 13-month-old child with hemiparesis was constrained with a soft removable mitt. Caregivers performed CIMT in 2 intense periods and weaning periods, and a home exercise period. Two independent raters performed video analysis of the quantity and quality of upper extremity. All measures showed improvement. Reaches with the involved upper extremity increased from 8.9% to 41.0%. Use of advanced grasp patterns increased from 3.3% to 76.1%. Successful release of objects improved from 0% to 73.0%. Caregivers reported functional improvements and strong positive feedback regarding success, ease, and satisfaction with CIMT. This case demonstrates positive outcomes using a clinically feasible method of CIMT with far reaching implications on function.
Fergus
Andrea
A
Division of Physical Therapy, Shenandoah University, Winchester, Virginia 22601, USA. afergus@su.edu
Buckler
Jessica
J
Farrell
Janeen
J
Isley
Melinda
M
McFarland
Meghan
M
Riley
Bonnie
B
D005260:Female; D006801:Humans; D007223:Infant; D009043:Motor Activity / Q000502:physiology; D009788:Occupational Therapy / Q000379:methods; D010291:Paresis / Q000503:physiopathology / Q000534:rehabilitation*; D026741:Physical Therapy Modalities / Q000295:instrumentation*; D020127:Recovery of Function; D012149:Restraint, Physical / Q000379:methods*; D016896:Treatment Outcome; D034941:Upper Extremity; D014743:Videotape Recording