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High-Dose Constraint-Induced Movement Therapy Beneficial for Cerebral Palsy

THURSDAY, Oct. 21, 2021 -- For children with hemiparetic cerebral palsy, high-dose constraint-induced movement therapy (CIMT) produces more consistent gains than usual customary treatment (UCT), according to a study published online Oct. 14 in Pediatrics.

Sharon Landesman Ramey, Ph.D., from the Fralin Biomedical Research Institute in Blacksburg, Virginia, and colleagues randomly assigned 118 2- to 8-year-olds with hemiparetic cerebral palsy to one of two doses and two constraint types of CIMT versus UCT. Participants were assessed at baseline, end of treatment, and six months after treatment.

The researchers found that when analyzing individual blinded outcomes, parent reports, and rank-order gains, findings varied in statistical significance. Regardless of constraint type, high-dose CIMT consistently produced a pattern of greatest short- and long-term gains (1.7 percent probability of occurring by chance alone) and significant gains at six months on visual motor integration and dissociated movement. High-dose CIMT produced significantly greater improvement than a moderate dose or UCT in O'Brien's rank-order analyses. In parent-reported functioning, there was significantly greater improvement for all CIMT groups versus UCT. Objective gains were revealed for children with UCT (e.g., 48 percent exceeded the smallest-detectable assisting hand assessment change compared with 71 percent for high-dose CIMT at the end of treatment).

"High doses of CIMT delivered in three-hour sessions five days per week for four weeks produced a consistent pattern of gains more than that of UCT on almost all blinded and parent-reported functional outcomes, although the findings are complex," the authors write.

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