Multicenter randomized controlled trial of pediatric constraint-induced movement therapy: 6-month follow-up

Am J Occup Ther. Jan-Feb 2012;66(1):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 3 to 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: The 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.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cerebral Palsy / rehabilitation*
  • Child
  • Child, Preschool
  • Exercise Movement Techniques*
  • Female
  • Follow-Up Studies
  • Functional Laterality
  • Humans
  • Male
  • Motor Skills / physiology
  • Occupational Therapy*
  • Restraint, Physical*
  • Treatment Outcome