This investigation assessed selected gait parameters of children with hemiparesis before and after participation in a modified constraint-induced movement therapy program (mCIMT). Recent advances in the understanding of the relationship between mCIMT and cortical reorganization supports the use of upper-extremity mCIMT to treat lower extremity deficits. However, the effects of mCIMT on the gait patterns of children with hemiparesis remain unclear. Twelve preschool children participated in a mCIMT program for 5 consecutive days, 6 h each day. Pre- and post-intervention data, on the temporal-spatial aspects of gait, were collected with the GAITRite walkway. Data were analyzed using a repeated measures generalized linear model. Base of support decreased significantly (p < 0.001) following treatment and improvements were noted in most other gait descriptors. The results of this study suggest that mCIMT can increase stability and improve the overall gait pattern. This study provides a new dimension in the effects of pediatric mCIMT programs and could begin to shift the focus of this intervention to remediation of lower extremity deficits. Additional studies with a longitudinal follow-up focus to determine the long-term effects of mCIMT on walking balance and stability would be beneficial.

The constant changing health care system has made it imperative for occupational therapists (OTs) to examine the effectiveness of treatment interventions with children. Few studies exist examining play as the desired outcome of the intervention. Previous studies in occupational therapy (OT) have focused on the motor aspects of play in children (Anderson, Hinojosa & Strauch, 1987; Florey, 1981; Morrison, Bundy, & Fisher, 1991). In these studies, the researchers hypothesize that improving motor skills will improve play skills in children. OTs frequently evaluate play using the Preschool Play Scale (PPS) (Bledsoe & Shephard, 1982; Knox, 1997) which provides a developmental age for play skills. Therapists also use developmental assessments designed to examine the skills used during play (Bundy, 1991). Skills used in play are important but fail to look at a child's approach or attitude during play. A child's approach to activities of play is termed "playfulness" (Bundy, 1997). The Test of Playfulness (TOP) (Bundy, 1997) was developed to measure this construct. The TOP provides information that can assist therapists working with children in designing measurable playfulness goals. This study examined the playfulness of four children who received OT intervention specifically designed to improve play behaviors in comparison to four children who did not receive this intervention. The results provide therapists with information and insight for treating children with play deficits. This information will help therapists design effective treatment to increase playfulness in children.

No abstract