Forced Use of the Upper Extremity in Cerebral Palsy: A Single-Case Design

Crocker, Michelle D.; MacKay-Lyons, Marilyn; McDonnell, Elizabeth

doi:10.5014/ajot.51.10.824

Cited by 90 publications

(63 citation statements)

References 2 publications

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“…According to a recent Cochrane review, 2 CIMT and modified CIMT (mCIMT) should be distinguished from forced use therapy (FUT), which merely imposes a restraint on the unaffected upper limb. In the past few years, an increasing number of studies have indicated positive (m)CIMT effects on the potential of the affected arm to assist the unaffected arm during bimanual activities, 6,7 as well as on the quality, speed, and dexterity of upper limb function, [7][8][9][10][11][12][13][14][15] the spontaneous use of the affected arm, 8,9,11 and the level of independence in self-care. [7][8][9][12][13][14] However, the restraint method for the affected arm varied greatly (sling, splint, glove, cast), as well as the intensity and length of the restraint (from 8 hours daily during 2-3 weeks to 2 hours daily for 8 weeks).…”

Section: Constraint Induced Movement Therapy (Cimt)mentioning

confidence: 99%

Effectiveness of Modified Constraint-Induced Movement Therapy in Children With Unilateral Spastic Cerebral Palsy: A Randomized Controlled Trial

Aarts

Jongerius

Geerdink

et al. 2010

Neurorehabil Neural Repair

159

190

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Background. In children with unilateral spastic cerebral palsy (CP), there is only limited evidence for the effectiveness of modified constraint-induced movement therapy (mCIMT). Objective. To investigate whether 6 weeks of mCIMT followed by 2 weeks of bimanual task-specific training (mCIMT-BiT) in children with unilateral spastic CP improves the spontaneous use of the affected limb in both qualitative and quantitative terms more than usual care (UC) of the same duration. Methods. Children with unilateral spastic CP with Manual Ability Classification System (MACS) scores I, II, or III and aged 2.5 to 8 years were recruited and randomly allocated to either the mCIMT-BiT group (three 3-hour sessions per week: 6 weeks of mCIMT, followed by 2 weeks of task-specific training in goal-directed bimanual play and self-care activities) or to 1.5 hours of more general physical or occupational weekly plus encouragement to use the affected hand for the UC group. Primary outcome measures were the Assisting Hand Assessment and the ABILHAND-Kids. Secondary outcomes were the Melbourne Assessment of Unilateral Upper Limb Function, the Canadian Occupational Performance Measure, and the Goal Attainment Scale. Results. Twenty-eight children were allocated to mCIMT-BiT and 24 to UC. Except for the Melbourne, all primary and secondary outcome measures demonstrated significant improvements in the mCIMT-BiT group. Conclusion. mCIMT followed by task-specific training of goal-directed bimanual play and self-care activities is an effective intervention to improve the spontaneous use of the more affected upper limb in children with relatively good baseline upper extremity function.

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Section: Constraint Induced Movement Therapy (Cimt)mentioning

confidence: 99%

Effectiveness of Modified Constraint-Induced Movement Therapy in Children With Unilateral Spastic Cerebral Palsy: A Randomized Controlled Trial

Aarts

Jongerius

Geerdink

et al. 2010

Neurorehabil Neural Repair

159

190

View full text Add to dashboard Cite

show abstract

“…Only one study designated the length of time that a child exhibited hemiplegia as an inclusion criteria, i.e., chronic vs. acute (Willis et al, 2002). In addition, sensory integrity and/or amount of active movement in the involved wrist and hand were used to determine suitability for participation for children in six of the studies (Yasukawa et al, 1990;Crocker et al, 1997;Charles et al, 2001;Eliasson et al, 2003; (Taub & Wolf, 1997). Specifically, restraints that allow some use of the non-involved extremity will result in less intensive practice because the non-involved arm can still be used to complete tasks.…”

Section: Inclusion Criteriamentioning

confidence: 99%

“…The following different types of restraints were used during the restraint period in the pediatric studies: casts (Yasukawa, 1990;Glover et al, 2002;Willis et al, 2002;DeLuca et al, 2003), resting splints (Crocker, 1997;Glover et al, 2002;Eliasson et al, 2003), slings (Charles et al, 2001;Charles et al, unpublished;unpublished), mitts (Pierce et al, 2002;Karman et al, 2003), and gentle intermittent physical restraint (Naylor & Bower, in press). Whereas each study described the extent of the restraint (usually by how much of the extremity was covered by the restraining device), few studies provided a rationale for employing a particular type of restraint.…”

Section: Inclusion Criteriamentioning

confidence: 99%

A Critical Review of Constraint‐Induced Movement Therapy and Forced Use in Children With Hemiplegia

2005

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Hemiplegia is a physical impairment that can occur in childhood following head hemiplegia. In this review, we provide a brief description of forced use and CI therapy and their historical basis, provide a summary of studies of these interventions in children, and discuss a number of important theoretical considerations, as well as implications for postural control. We will show that whereas the studies to date suggest that both forced use and CI therapy appear to be promising for improving hand function in children with hemiplegia, the data are limited. Substantially more work must be performed before this approach can be advocated for general clinical use.

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“…Occupational therapy for children with CP 13 Multidisciplinary, outcome measures not included in review Case-Smith 22 Participants with CP and other diseases Colbert 23 Outcome measures not included in review Crawford 24 Outcome measures not included in review Damle 25 Outcome measures not included in review Fetters 26 Outcome measures not included in review Fisher 27 Participants with CP and other diseases Hankinson 28 Outcome measures not included in review Hasdai 29 Participants with CP and other diseases Hulme 30 Participants with CP and other diseases Hulme 31 Participants with CP and other diseases Manley 32 Outcome measures not included in review Palmer 33 Outcome measures not included in review Reid 34 Outcome measures not included in review Rennie 35 Participants with CP and other diseases Barnes 36 Single subject design Barnes 37 Single subject design Crocker 38 Single subject design Durfee 39 Single subject design Everson 40 Single subject design, outcome measures not included in review Goodman 41 Single subject design Hsieh 42 Single subject design Hulme 43 Single subject design, participants with CP and other diseases Kinghorn 44 Single subject design Lilly 45 Single subject design McCormack 46 Single subject design Reid 47 Single subject design Sakemiller 48 Single subject design Smiths 49 Single subject design Tona 50 Single subject design…”

Section: Appendix 1 -Criteria Of Methodological Qualitymentioning

confidence: 99%

Occupational therapy for children with cerebral palsy: a systematic review

et al. 2004

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Objective: Occupational therapy (OT) for cerebral palsy focuses on the development of skills necessary for the performance of activities of daily living. The aim of this systematic review was to determine whether OT interventions improve outcome for children with cerebral palsy (CP). Methods: An extensive search in MEDLINE, CINAHL, EMBASE, AMED and SCISEARCH was performed. Studies with controlled and uncontrolled designs were included. Six intervention categories were distinguished and individually analysed using a best-evidence synthesis. This synthesis is based on the type of design, the methodological quality, the type of outcome measures and the statistical signi cance of the ndings. Results: Seventeen studies were included in this review, seven of which were randomized controlled trials (RCTs). One RCT had a high methodological quality. The analyses resulted in insuf cient evidence of the ef cacy of occupational therapy in all intervention categories, due to the low methodological quality of studies presenting statistically nonsigni cant results. Conclusion: Despite the reasonable number of studies identi ed, the inconclusive ndings regarding the ef cacy of occupational therapy for children with cerebral palsy may be a re ection of the dif culties in ef cacy research in OT for children with CP. Future research should critically re ect on methodological issues.

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Forced Use of the Upper Extremity in Cerebral Palsy: A Single-Case Design

Abstract: Although the results of this single-case design are encouraging, further research with a randomized, controlled design is necessary to determine the effectiveness of the forced-use technique with a larger population.

Cited by 90 publications

References 2 publications

Effectiveness of Modified Constraint-Induced Movement Therapy in Children With Unilateral Spastic Cerebral Palsy: A Randomized Controlled Trial

Effectiveness of Modified Constraint-Induced Movement Therapy in Children With Unilateral Spastic Cerebral Palsy: A Randomized Controlled Trial

A Critical Review of Constraint‐Induced Movement Therapy and Forced Use in Children With Hemiplegia

Occupational therapy for children with cerebral palsy: a systematic review

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