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.