Effects of constraint-induced movement therapy on hand skills and muscle recruitment of children with spastic hemiplegic cerebral palsy.
BACKGROUND
Constraint-Induced Movement Therapy (CIMT) is a therapeutic intervention using constraint of the less-affected limb and intensive use of the hemiplegic extremity in individuals with hemiplegia. The purpose of this study was to determine whether children with cerebral palsy (CP) who have undergone a 2-week function-based CIMT show improved hand function and underlying muscle activation changes associated with functional gains.


METHODS
Six children with hemiplegic CP participated in the study, receiving 4 hours of therapy 5 days a week coupled with bi-valve casts worn 8-12 hours for 14 days. Outcome measures of grip strength, pinch strength, dexterity tests and electromyography (EMG) were compared before, immediately post- and 3 months post-intervention.


RESULTS
Repeated measures ANOVA and post hoc paired t-tests showed significant group improvements in all strength and dexterity measures (p < 0.05). EMG analysis showed significant increases in muscle activation on pinch measures (p = 0.05). Visual inspection of the EMG data suggested increased muscle activation during grip and a decrease in the muscle activation required during dexterity tasks.


CONCLUSIONS
Our preliminary results support CIMT for improving strength and dexterity in children with hemiplegic CP. Further studies with greater sample sizes and longer study periods are recommended to determine muscle activation changes post CIMT.
Stearns
Ginny E
GE
Occupational Therapy Program, Department of Pediatrics, School of Medicine, University of New Mexico, Albuquerque, New Mexico, USA. gstearns@salud.unm.edu
Burtner
Patricia
P
Keenan
Kristina M
KM
Qualls
Clifford
C
Phillips
John
J