Pediatric Constraint-Induced Movement Therapy for a Young Child With Cerebral Palsy: Two Episodes of Care

This case report describes the use of "Pediatric Constraint-Induced Therapy (Pediatric CI Therapy)" given on 2 separate occasions for a young child with quadriparetic cerebral palsy. The child was 15 months of age at the beginning of the first episode of care. She had previously received w...

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Bibliographic Details
Published in:Physical therapy 2003-11, Vol.83 (11), p.1003-1013
Main Authors: DeLuca, Stephanie C, Echols, Karen, Ramey, Sharon L, Taub, Edward
Format: Article
Language:English
Subjects:
Care and treatment
Cerebral palsied children
Cerebral palsy
Cerebral Palsy - physiopathology
Cerebral Palsy - rehabilitation
Children & youth
Early intervention
Episode of Care
Evaluation
Exercise therapy
Female
Hemiplegia - physiopathology
Hemiplegia - rehabilitation
Humans
Infant
Methods
Movement therapy
Paralysis
Physical therapy
Physical Therapy Modalities - methods
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Summary:This case report describes the use of "Pediatric Constraint-Induced Therapy (Pediatric CI Therapy)" given on 2 separate occasions for a young child with quadriparetic cerebral palsy. The child was 15 months of age at the beginning of the first episode of care. She had previously received weekly physical therapy and occupational therapy for 11 months, but she had no functional use of her right upper extremity (UE), independently or in an assistive manner. She scored from 5 to 7 months below her chronological age on developmental assessments in gross motor, fine motor, and self-help skills. Pediatric CI Therapy involved placement of a full-arm, bivalved cast on the child's less affected UE while providing 3 weeks of intensive intervention (6 hours a day) for the child's more affected UE (intervention 1). Therapy included activities that were goal oriented but broken down into progressively more challenging step-by-step tasks. Pediatric CI Therapy was administered again 5 months later to promote UE skills and independence (intervention 2). The child developed new behaviors throughout both interventions. During intervention 1, the child developed independent reach, grasp, release, weight bearing (positioned prone on elbows) of both UEs, gestures, self-feeding, sitting, and increased interactive play using both UEs. During intervention 2, she had increased independence and improved quality of UE movement, as supported by blinded clinical evaluations and parent ratings.
ISSN:0031-9023
1538-6724
DOI:10.1093/ptj/83.11.1003