Affiliations: [a] Children’s Minnesota-Maple Grove, Physical Medicine and Rehabilitation, Maple Grove, MN, USA | [b] Children’s Minnesota Research Institute, Children’s Minnesota, Minneapolis, MN, USA
Corresponding author: Kathy Grinde, Children’s Minnesota-Maple Grove, Physical Medicine and Rehabilitation, 7767 Elm Creek Blvd, Suite 300, Maple Grove, MN, 55369, USA. Tel.: +1 763 4168712; Fax: +1 763 4168701; E-mail: [email protected].
Abstract: PURPOSE: To examine the results of repeated episodes of 21-day pediatric constraint induced movement therapy (PCIMT) paired with gross motor training (GMT). METHODS: Nineteen children, age 14 months – 6 years with unilateral upper extremity impairment enrolled in this cohort study to receive repeated episodes of 21 day PCIMT-GMT. Outcome measures included the Peabody Developmental Motor Scales-2 (PDMS-2), the Assisting Hand Assessment (AHA) and the Canadian Occupational Performance Measure (COPM). RESULTS: All children demonstrated improvement in raw scores following each episode of PCIMT-GMT with a statistically significant change in the least squares estimated mean for all measures except the PDMS-2 total motor raw score and gross motor quotient for the preferred hand in the fourth episode (p< 0.05). Gains were noted on the Scaled Score for the AHA for 39/39 episodes, all greater than the smallest detectable difference. COPM Performance and Satisfaction scores for 17/17 episodes were above the clinically meaningful threshold. Additional improvements in scores were noted in all children with each repeated episode. CONCLUSION: Children with unilateral upper extremity impairment demonstrate improvements in fine motor, gross motor, and bimanual skills, along with functional changes in participation in daily life, following PCIMT-GMT. Participation in repeated episodes can lead to further improvements.
Keywords: Pediatric, cerebral palsy, paresis, constraint induced movement therapy, hand function, intensive training