Research Article  |   January 2012
Multicenter Randomized Controlled Trial of Pediatric Constraint-Induced Movement Therapy: 6-Month Follow-Up
Author Affiliations
  • Jane Case-Smith, EdD, OTR/L, FAOTA, is Director, Occupational Therapy Division, Ohio State University, 406 Atwell Hall, 453 West 10th Avenue, Columbus, OH 43210; Jane.Case-Smith@osumc.edu
  • Stephanie C. DeLuca, PhD, is Assistant Professor, Department of Occupational Therapy, University of Alabama at Birmingham
  • Richard Stevenson, MD, is Professor of Pediatrics, University of Virginia, Charlottesville
  • Sharon Landesman Ramey, PhD, is Distinguished Scholar and Professor, Virginia Tech Carilion Research Institute, Roanoke
Article Information
Neurologic Conditions / Pediatric Evaluation and Intervention / Children and Youth
Research Article   |   January 2012
Multicenter Randomized Controlled Trial of Pediatric Constraint-Induced Movement Therapy: 6-Month Follow-Up
American Journal of Occupational Therapy, January/February 2012, Vol. 66, 15-23. doi:10.5014/ajot.2012.002386
American Journal of Occupational Therapy, January/February 2012, Vol. 66, 15-23. doi:10.5014/ajot.2012.002386
Abstract

OBJECTIVE. Pediatric constraint-induced movement therapy (CIMT) is a promising intervention for children with unilateral cerebral palsy (CP). This multisite randomized controlled trial (RCT) tested the hypothesis that 6 hr versus 3 hr per day for 21 days would produce larger maintenance of gains 6 mo posttreatment.

METHOD. Three sites recruited 18 children (6 per site) ages 3–6 yr with unilateral CP. Children were randomly assigned to 3 or 6 hr/day of CIMT for 21 days and wore a cast on the unaffected extremity the first 18 days. Occupational therapists applied a standardized pediatric CIMT protocol. Evaluators blinded to condition administered the Assisted Hand Assessment and the Quality of Upper Extremity Skills Test, and parents completed the Pediatric Motor Activity Log pre- and posttreatment (1 wk, 1 mo, and 6 mo).

RESULTS. Both CIMT dosage groups showed significant gains on all five assessments with no significant group differences at 6-mo follow-up. Effect sizes (n = 15) comparing preintervention to postintervention measures (partial η2) ranged from .33 to .80.

CONCLUSION. This first multisite RCT of pediatric CIMT confirmed the maintenance of positive effects at 6 mo follow-up across multiple functional performance measures. The hypothesis that maintenance of effects would differ for children who received 6 versus 3 hr/day of CIMT (126 vs. 63 total hr) was not supported.