A recently published meta-analysis of randomized controlled trials (RCTs) supports the use of constraint-induced movement therapy (CIMT) for children with cerebral palsy (CP) as an effectual intervention for upper-limb function. The study, published in Clinical Rehabilitation, examined 27 RCTs between 2004 and 2014 that included 894 participants with CP, ranging in ages from 2.4 to 10.7 years. The majority of studies focused on a 5-day-per-week intervention over the course of 2 to 3 weeks, with restraints including slings, casts, gloves, and mittens, according to an American Physical Therapy Association (APTA) news release.
The authors of the study write that the studies showed a medium effect of CIMT on arm function, which they describe as “similar to the effect of [CIMT] when used in adults with stroke.” The researchers then applied the International Classification of Functioning, Disability and Health (ICF) model to the results, finding that CIMT resulted in medium improvements to activity level immediately after the intervention as well as to participation level during follow-up.
The APTA news release indicates that according to the study, effectiveness was also affected by the location of the intervention with home-based settings producing better results than clinic or camp-based settings. The study’s authors write, “The natural environment … offered less distress during [CIMT] practice for both children with cerebral palsy and their parents,” the authors write. “Further, the training schedule can be tailored to fit into the family’s daily routine.”
The CIMT approach did not fare as well when a longer follow-up time was used, however, writing that this is “consistent with the logical assumption that the [CMIT] effect could not be maintained over time.” In addition, when compared to dose-equivalent groups, the groups receiving CIMT showed only “slightly better” results, as opposed to the “large effect” observed when compared to interventions that were not dose equivalent, as noted on the APTA news release.