EFFICACY OF CONSTRAINT-INDUCED MOVEMENT THERAPY INTERVENTION FOR CHILDREN WITH CEREBRAL PALSY Andria Vetsch Mentor: Dr. Jane Case-Smith The Ohio State University, Occupational Therapy Division and University of Wisconsin-River Falls Introduction Cerebral Palsy(CP) Spastic Hemiplegic CP Constraint-Induced Movement Therapy(CIMT) 4,5 Features of CIMT Constraint of the non-affected limb Forced use of the involved upper extremity Intensive treatment Education of parents Past Research Improved hand-movement efficiency2 Hands to midline forearm supination and pronation transferring a cube between hands ulnar/palmer grasping with the hands Investigated the protocol (length, frequency of treatment, populations participating) 1,3,5 Lack of research on fidelity of treatment Purpose 1) Assess the consistency in which therapists administer CIMT in a pediatric hospital outpatient setting. 2) Assess inter-rater reliability of the fidelity measure used to score these consistencies. 3) Evaluate the effects of CIMT on a cohort of children with hemiparetic CP Methods CIMT participants from NCH Fidelity measure participants 10 children 4 children Age range: 10 months- 13years Age range: 21months-10years Mean age: 3 years Mean age: 5 years 6 females, 4 males 3 females, 1 male Affected limbs: 6 right, 4 left Affected limb: 4 right Pre-Post assessment scores were collected at Nationwide Children’s Hospital (NCH) Video recordings were taken throughout treatment session and scored by three raters Mean scores Mean Score for Pre-Post Test Rater 1 2 3 Mean Fidelity Rating Mean rating for Mean rating for Therapist child 2.43 2.07 2.14 2.00 2.25 1.69 Conclusion Pre-Post test scores improved Consistency can lead to improved efficacy of therapy Promote the development of new skills and help to generalize skills in a variety of settings Developing a fidelity measure for CIMT and tracking child outcomes Further Research Continue to assess the administration of CIMT Continue to research the effects of CIMT Questions? Thanks to SROP at Ohio State, Dr. Jane Case-Smith, and the University of Wisconsin River-Falls McNair Program for the opportunity to participate in this unique research project. References 1. Case-Smith, J., and O’Brien,JC. Occupational Therapy for Children. 6th ed. Maryland Heights, MO: Mosby/Elsevier, (2010) Print. 2. DeLuca, Stephanie C., Karen Echols, Charles R. Law, and Sharon L. Ramey. "Intensive Pediatric Constraint-Induced Therapy for Children With Cerebral Palsy: Randomized, Controlled, Crossover Trial." Journal of Child Neurology 21.11 (2006): 931-38. Print. 3. Deluca,SC,Echols,K,Ramey,SL, Taub,E. Pediatric constraint-induced movement therapy for a young child: tow episodes of care. Phy Ther. (2003): 1003-1013Print. 4. Gordon,Andrew M., Charles,Jeanne, Wolf, Steven L. "Methods of Constriant-Induced Therapy for Children with Hemiplegic Cerebral Palsy: Development of a Child-Friendly Intervention for Improving Upper-Extremity Function." Phys. Med. Rehabilitaion 86(2005): 837-44. Print. 5. Taub, Edward, Sharon Landesman Ramey, Stephanie DeLuca, and Karen Echols. "Efficacy of Constraint-Induced Movement Therapy for Children with Cerebral Palsy with Asymmetric Motor Impairment." Pediatrics 113.2 (2004): 305-12. Print.