efficacy of constraint-induced movement therapy intervention for children with cerebral palsy
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Efficacy of Constraint-Induced Movement Therapy Intervention for Children with Cerebral Palsy. Andria Vetsch Mentor: Dr. Jane Case-Smith The Ohio State University, Occupational Therapy Division and University of Wisconsin-River Falls. Introduction. Cerebral Palsy(CP) Spastic Hemiplegic CP - PowerPoint PPT PresentationTRANSCRIPT
EFFICACY OF CONSTRAINT-INDUCED MOVEMENT THERAPY INTERVENTION FOR CHILDREN WITH CEREBRAL PALSYAndria VetschMentor: Dr. Jane Case-SmithThe Ohio State University, Occupational Therapy Division and University of Wisconsin-River Falls
IntroductionCerebral Palsy(CP)Spastic Hemiplegic CPConstraint-Induced Movement
Therapy(CIMT)Features of CIMT
Constraint of the non-affected limb Forced use of the involved upper extremity Intensive treatment Education of parents
4,5
Past Research Improved hand-movement efficiency
Hands to midline forearm supination and pronation transferring a cube between hands ulnar/palmer grasping with the hands
Investigated the protocol (length, frequency of treatment, populations participating)
Lack of research on fidelity of treatment
1,3,5
2
Purpose1) Assess the consistency in which
therapists administer CIMT in a pediatric hospital outpatient setting.
2) Assess inter-rater reliability of the fidelity measure used to score these consistencies.
3) Evaluate the effects of CIMT on a cohort of children with hemiparetic CP
Methods
Mean age: 3 years
6 females, 4 males
Affected limbs: 6 right, 4 leftPre-Post assessment scores were collected at Nationwide
Children’s Hospital (NCH)
Fidelity measure participants
4 children
Age range: 21months-10years
Mean age: 5 years
3 females, 1 male
Affected limb: 4 rightVideo recordings were taken
throughout treatment session and scored by three raters
Mean Score for Pre-Post Test
Mea
n sc
ores
Mean Fidelity RatingRater Mean rating
for TherapistMean rating
for child
1 2.43 2.002 2.07 2.253 2.14 1.69
Conclusion Pre-Post test scores
improved Consistency can lead
to improved efficacy of therapy
Promote the development of new skills and help to generalize skills in a variety of settings
Developing a fidelity measure for CIMT and tracking child outcomes
Further Research Continue to assess the
administration of CIMT Continue to research the effects of
CIMT
Questions? Thanks to SROP
at Ohio State, Dr. Jane Case-Smith, and the University of Wisconsin River-Falls McNair Program for the opportunity to participate in this unique research project.
References1. Case-Smith, J., and O’Brien,JC. Occupational Therapy for Children. 6th ed.
Maryland Heights, MO: Mosby/Elsevier, (2010) Print.
2. DeLuca, Stephanie C., Karen Echols, Charles R. Law, and Sharon L. Ramey. "Intensive Pediatric Constraint-Induced Therapy for Children With Cerebral Palsy: Randomized, Controlled, Crossover Trial." Journal of Child Neurology 21.11 (2006): 931-38. Print.
3. Deluca,SC,Echols,K,Ramey,SL, Taub,E. Pediatric constraint-induced movement therapy for a young child: tow episodes of care. Phy Ther. (2003): 1003-1013Print.
4. Gordon,Andrew M., Charles,Jeanne, Wolf, Steven L. "Methods of Constriant-Induced Therapy for Children with Hemiplegic Cerebral Palsy: Development of a Child-Friendly Intervention for Improving Upper-Extremity Function." Phys. Med. Rehabilitaion 86(2005): 837-44. Print.
5. Taub, Edward, Sharon Landesman Ramey, Stephanie DeLuca, and Karen Echols. "Efficacy
of Constraint-Induced Movement Therapy for Children with Cerebral Palsy with
Asymmetric Motor Impairment." Pediatrics 113.2 (2004): 305-12. Print.