Effect of Upper-Extremity Constraint-Induced Movement Therapy on Gross Motor Outcomes in Children with Cerebral Palsy: Systematic Review

Phys Occup Ther Pediatr. 2025;45(6):833-847. doi: 10.1080/01942638.2025.2525881. Epub 2025 Jul 10.

Abstract

Aims: This study aimed to evaluate the impact of upper-extremity constraint-induced movement therapy (UE-CIMT) on gross motor skills, postural control, and lower extremity function in children with hemiplegic cerebral palsy (CP).

Methods: The electronic databases PubMed, CINAHL, Scopus, and Ovid were searched for eligible articles using the following keywords: "cerebral palsy," "children," "CIMT," "gross motor skills," "postural control," "balance," and "gait." Quality assessment of eligible studies was performed using the PEDro scale.

Results: Out of 919 identified papers, nine met the inclusion criteria. Findings suggest potential benefits in improving gross motor skills, postural control, and lower extremity function, as shown by measures such as the Gross Motor Function Measure (GMFM), the Peabody Developmental Motor Scales (PDMS-2), and gait parameters. However, methodological heterogeneity limits the strength of evidence.

Conclusion: While CIMT primarily targets UE function, emerging evidence suggests its influence may extend to gross motor skills. This highlights the potential for UE-CIMT to support broader motor improvements beyond the targeted limb. However, the quality of existing evidence is limited due to methodological weaknesses, small sample sizes, and variability in study design. Well-designed trials are needed to validate these findings and contribute to holistic rehabilitation approaches optimizing interventions for children with CP.

Keywords: Balance; cerebral palsy; children; constraint-induced movement therapy (CIMT); gait; gross motor skills; lower extremity function; postural control.

Publication types

  • Systematic Review

MeSH terms

  • Cerebral Palsy* / physiopathology
  • Cerebral Palsy* / rehabilitation
  • Child
  • Exercise Therapy* / methods
  • Humans
  • Lower Extremity / physiopathology
  • Motor Skills* / physiology
  • Postural Balance
  • Restraint, Physical*
  • Upper Extremity* / physiopathology