Podcast: Constraint-induced movement therapy in the treatment of the upper limb in children with unilateral cerebral palsy

Cerebral palsy is the most common form of childhood disability, and there are several Cochrane Reviews of therapies that might help the children and their families. These include a review on constraint-induced movement therapy, which was updated in April 2019. We asked lead author Brian Hoare from Monash Children ’s Hospital in Australia to tell us about this treatment, and the evidence on its effects.A large proportion of children with cerebral palsy, or CP, have unilateral CP, which is also known as hemiplegic CP. This affects muscle control and function on one side of the body and is the focus of our review. Children with unilateral CP find it difficult to use their hands together and will often disregard the more affected arm. Constraint-induced movement therapy, or CIMT, aims to increase use of this arm and improve how children with unilateral CP use their two hands together to perform daily tasks. It ’s based on two principles: restraining the use of the less affected arm (for example, using a splint, mitt or sling) and intensive therapeutic practice of the more affected arm.In our Cochrane review, we look at direct comparisons of CIMT and comparisons against other interventions, which we analyzed in groups depending on the relative dosage of those other interventions. Among a range of outcomes, we were particularly interested in evaluating the effect of CIMT on how children with unilateral CP use their two hands together, which goes by the technical term: bimanual ...
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