Constraint-Induced Movement Therapy and Cerebral Palsy

Cerebral Palsy Treatments, Therapies

young girl with hand in a cast using other hand to draw

Constraint-induced movement therapy (CIMT) helps children and adults develop their ability to use a hand or limb that has been weakened by cerebral palsy. This innovative, non-invasive therapy is an excellent option for helping your child with cerebral palsy improve their fine motor skills and independence.

What Is Constraint-Induced Movement Therapy?

The philosophy behind CIMT is that by limiting the use of a stronger, more functional arm or hand, the weaker counterpart will be forced to be more able to perform the same tasks. For children with cerebral palsy, the more functional arm and hand are placed in a cast, sling, or mitt to constrain their movements. This requires your child to use the affected arm and hand to perform tasks that the opposite arm and hand would normally perform.

The length of the CIMT depends on the institution that offers it. Generally, the therapy may last two or three weeks. While your child is in the CIMT program, they may be required to spend a certain number of days in outpatient instruction, such as five days a week.

During these outpatient visits, your child may be asked to perform tasks with their affected arm and hand. These tasks may include repetitive exercises that are designed to rewire the brain to tell the affected arm to make the same movements as the less-affected arm. If all goes well, after the program, your child may be better able to use their affected upper extremity, improving their quality of life.

How Does CIMT Treat Cerebral Palsy?

CIMT is particularly effective for children with unilateral cerebral palsy. This form of cerebral palsy affects the side of the body opposite to the side of the brain that has been damaged. CIMT can help children with unilateral cerebral palsy focus on developing the affected side of their body to gain fine motor skills and a better range of motion.

A successful CIMT program will achieve its goal of improving the overall function of the affected arm or hand. This may give your child the use of both of their arms and hands, allowing them to perform more tasks that require both hands.

Since the success rate of CIMT programs is hard to measure or qualify, there is a lack of numerical proof for its efficacy. However, anecdotal accounts and studies have shown that CIMT treatment is a potentially effective way to improve motor functions in affected limbs, especially in children with hemiplegic cerebral palsy.

How Can I Determine If My Child Is a Good Candidate?

If your child has unilateral cerebral palsy or hemiplegia, they may benefit from a CIMT program. If your child has developed a learned non-use favoritism of one arm over the other, they may also benefit, though some programs require that your child have a unilateral upper extremity impairment due to a neurological condition such as cerebral palsy to be eligible for the treatment.

If your child is simply unable to move the affected arm or hand, you may want to consider a different approach that restores the use of that arm or hand. Your child may be required to wear the constraint for the entirety of the program or for 90% of every day. If you don’t think that your child will be able to wear the constraint for this extended time, you might consider waiting before enrolling them in CIMT.

As with most therapies, CIMT involves preliminary evaluation to see if your child is eligible or would benefit from the program. It’s important that you or a caregiver has enough time in the day and throughout the week to dedicate themselves to transporting your child to and from the outpatient portion of the program and to perform any necessary tasks at home.

What to Ask Your Doctor About Constraint-Induced Movement Therapy

Ask your doctor for general advice as to whether they think your child will benefit from the CIMT program. Your doctor may be able to suggest an institution or outpatient program that offers a CIMT program. If you have any questions or concerns about the pediatric protocol of a CIMT, your doctor, or a healthcare professional who specializes in CIMT may be able to help you. The cost of the program varies, so be sure to ask your trusted healthcare professional what they estimate the cost will be.

You can also search for a CIMT provider in your area and speak to them directly about your child’s eligibility. During your child’s evaluation, you should be able to ascertain exactly what the program entails.

Our expert team of Cerebral Palsy Family Lawyers at Janet, Janet & Suggs, LLC have helped thousands of families review their options in cerebral palsy medical malpractice cases. Do you believe your child’s cerebral palsy is the result of medical negligence? Contact us today to let us help you explore your case.

 


 

Giles Manley
Reviewed by:
Giles H. Manley, M.D., J.D., F.A.C.O.G. | CPFN Medical Advisor
Board-Certified OBGYN | Medical Malpractice Attorney

Dr. Manley has delivered over 2,000 babies and uses his wealth of medical knowledge to uncover medical errors that were missed by others (keep in mind most CP cases involve errors committed at or around the time of birth). READ FULL BIO

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