Efficacy of modified constraint induced movement therapy in improving upper limb function in children with hemiplegic cerebral palsy: a randomized controlled trial

Abstract

Purpose: The objective of this randomized single blind (outcome assessor) controlled trial was to evaluate the efficacy of 4 weeks of modified constraint induced movement therapy (mCIMT) in improving upper limb function in 3-8 years old children with hemiplegic cerebral palsy.

Methods: Thirty-one children were randomly assigned to receive the mCIMT (N=16) with conventional therapy or conventional therapy alone (N=15). Children were evaluated three times (at enrollment, follow up at 4 weeks and 12 weeks). The primary outcome measure was difference in "change in mean total QUEST scores" at 4 weeks of intervention between the intervention and the control arm.

Results: After 4 weeks of intervention, mCIMT group showed significant change in the affected upper limb in QUEST scores (10.7 ± 5.2 vs 1.4 ± 1.7, p<0.001) and time (s) to complete nine-hole-pegboard test compared with control group [60(0-130) vs 5(-12 to 30), p<0.001]. The improvement observed in upper limb function after 4 weeks of intervention persisted 8 weeks after discontinuation of intervention in mCIMT group.

Conclusion: The modified constraint induced movement therapy appears to be effective in improving upper limb function in 3-8 years old hemiplegic cerebral palsy children.

Keywords: Forced use therapy; Hand function; Hemiplegic cerebral palsy; Nine hole peg board; QUEST.