Stephanie C. DeLuca, Sharon Landesman Ramey, Mary Rebekah Trucks, Dorian Ainsworth Wallace; Multiple Treatments of Pediatric Constraint-Induced Movement Therapy (pCIMT): A Clinical Cohort Study. Am J Occup Ther 2015;69(6):6906180010. https://doi.org/10.5014/ajot.2015.019323
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Pediatric constraint-induced movement therapy (pCIMT) is one of the most efficacious treatments for children with cerebral palsy (CP). Distinctive components of pCIMT include constraint of the less impaired upper extremity (UE), high-intensity therapy for the more impaired UE (≥3 hr/day, many days per week, for multiple weeks), use of shaping techniques combined with repetitive task practice, and bimanual transfer. A critical issue is whether multiple treatments of pCIMT produce additional benefit. In a clinical cohort (mean age = 31 mo) of 28 children with asymmetrical CP whose parents sought multiple pCIMT treatments, the children gained a mean of 13.2 (standard deviation [SD] = 4.2) new functional skills after Treatment 1; Treatment 2 produced a mean of 7.3 (SD = 4.7) new skills; and Treatment 3, 6.5 (SD = 4.2). These findings support the conclusion that multiple pCIMT treatments can produce clinically important functional gains for children with hemiparetic CP.
Repeated pCIMT treatments for young children with asymmetrical CP can produce large and significant benefits; the largest gains may occur after the first treatment.
pCIMT can be clinically implemented and produce large benefits on repeated occasions for a wide range of children (age and ability levels).
Children and families can repeat the full course of high-intensity treatment with no negative effects.
Subsequent pCIMT treatments produce gains over and above those of the first pCIMT treatment for most children.
Future research needs to include more sensitive outcome measures for children who function at higher levels after Treatment 1 and to consider the optimal length of intertreatment intervals (perhaps varying as a function of the child’s age, ability level, and treatment goals).
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