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Modified constraint-induced movement therapy in children with congenital hemiplegic cerebral palsy

Modified constraint-induced movement therapy in children with congenital hemiplegic cerebral palsy
Modified constraint-induced movement therapy in children with congenital hemiplegic cerebral palsy
One new treatment strategy for children with hemiplegic cerebral palsy (CP) is constraint-induced movement therapy (CIMT). CIMT combines restraint of the less affected upper extremity and intensive exercise with the affected limb. CIMT has been shown to be effective in adults following stroke but it is not clear whether or not CIMT can readily be incorporated into clinical practice either with adults or children. An intervention that may be more practical involves the restraint element of CIMT without additional exercise (Forced use therapy-FUT). FUT has been only sparsely investigated, especially in children with CP. Different versions of CIMT protocols have been suggested as being „child-friendly? but identifying a practical and effective protocol remains challenging. Part of a child-friendly protocol includes identification of the most appropriate type of constraint, as different splints have been used for different populations without justification of their selection. In this project, the aim was to identify the most appropriate splint from children?s and parents? perspective as reflected by effectiveness and adherence to home-based FUT (feasibility study) and to investigate the functional effects of a modified version of CIMT (mCIMT) (effectiveness study) that was designed based on the findings of the feasibility study. A further aim of the study was to compare the effect of additional functional activities and feedback with constraint alone. Two questions emerged as being important during the course of the project; the first addressed poor recruitment to the effectiveness study and explored parents and therapist? views on the practicality and effectiveness of both the classic paediatric protocol and the one suggested by the present study. The second was to provide insight into the physiological effects of CIMT or other treatments that might explain variations in response. In this study a test using the lateralised readiness potential (LRP) component of the EEG that was appropriate for young children was developed and evaluated with a small sample of unimpaired children and children with CP.
cerebral palsy, congenital hemiplegic cerebral palsy, movement therapy, children, constraint-induced
University of Southampton
Psychouli, Pavlina
46f17c61-f419-440e-b89e-501abd293303
Psychouli, Pavlina
46f17c61-f419-440e-b89e-501abd293303
Burridge, Jane
0110e9ea-0884-4982-a003-cb6307f38f64
Kennedy, Colin
7c3aff62-0a86-4b44-b7d7-4bc01f23ec93
Ashburn, Ann
818b9ce8-f025-429e-9532-43ee4fd5f991
Hogan, Alexandra
7e7820da-6e26-49f0-96ce-06638f88dc87

Psychouli, Pavlina (2008) Modified constraint-induced movement therapy in children with congenital hemiplegic cerebral palsy. University of Southampton, School of Health Sciences, Doctoral Thesis, 299pp.

Record type: Thesis (Doctoral)

Abstract

One new treatment strategy for children with hemiplegic cerebral palsy (CP) is constraint-induced movement therapy (CIMT). CIMT combines restraint of the less affected upper extremity and intensive exercise with the affected limb. CIMT has been shown to be effective in adults following stroke but it is not clear whether or not CIMT can readily be incorporated into clinical practice either with adults or children. An intervention that may be more practical involves the restraint element of CIMT without additional exercise (Forced use therapy-FUT). FUT has been only sparsely investigated, especially in children with CP. Different versions of CIMT protocols have been suggested as being „child-friendly? but identifying a practical and effective protocol remains challenging. Part of a child-friendly protocol includes identification of the most appropriate type of constraint, as different splints have been used for different populations without justification of their selection. In this project, the aim was to identify the most appropriate splint from children?s and parents? perspective as reflected by effectiveness and adherence to home-based FUT (feasibility study) and to investigate the functional effects of a modified version of CIMT (mCIMT) (effectiveness study) that was designed based on the findings of the feasibility study. A further aim of the study was to compare the effect of additional functional activities and feedback with constraint alone. Two questions emerged as being important during the course of the project; the first addressed poor recruitment to the effectiveness study and explored parents and therapist? views on the practicality and effectiveness of both the classic paediatric protocol and the one suggested by the present study. The second was to provide insight into the physiological effects of CIMT or other treatments that might explain variations in response. In this study a test using the lateralised readiness potential (LRP) component of the EEG that was appropriate for young children was developed and evaluated with a small sample of unimpaired children and children with CP.

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More information

Published date: November 2008
Keywords: cerebral palsy, congenital hemiplegic cerebral palsy, movement therapy, children, constraint-induced
Organisations: University of Southampton

Identifiers

Local EPrints ID: 71895
URI: https://eprints.soton.ac.uk/id/eprint/71895
PURE UUID: ca9a9ef9-5bfc-4475-a17d-f5e5cb82c14b
ORCID for Jane Burridge: ORCID iD orcid.org/0000-0003-3497-6725

Catalogue record

Date deposited: 18 Jan 2010
Last modified: 13 Sep 2019 00:38

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Contributors

Author: Pavlina Psychouli
Thesis advisor: Jane Burridge ORCID iD
Thesis advisor: Colin Kennedy
Thesis advisor: Ann Ashburn
Thesis advisor: Alexandra Hogan

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