SciELO - Scientific Electronic Library Online

 
vol.42 issue3Editorial CommentWomen surviving chronic poverty and psychiatric disability author indexsubject indexarticles search
Home Pagealphabetic serial listing  

South African Journal of Occupational Therapy

On-line version ISSN 2310-3833
Print version ISSN 0038-2337

S. Afr. j. occup. ther. vol.42 n.3 Pretoria  2012

 

ARTICLES

 

The effect of a repeated course of Constraint-Induced movement therapy, implemented in the home environment, on the functional skills of a young child with cerebral palsy

 

 

Ursula Hamer-RohrerI; Neeltje SmitII; Marlette BurgerIII

IBOT, MOccTher. Clinical supervisor, Department of Occupational therapy, Stellenbosch University
IIMOccTher, MBA. Senior lecturer, Department of Occupational Therapy at time of the study,Stellenbosch University
IIIBSc Physio, MSc Physio. Lecturer Department of Physiotherapy, Stellenbosch University

Correspondence

 

 


ABSTRACT

The lack of research in South Africa related to the use of Constraint-Induced Movement Therapy (CIMT) motivated this single-system (A-B-A-B-A) study The aim was to investigate whether a repeated course of CIMT would improve self-care, play and functional skills of a young boy with asymmetrical cerebral palsy (CP). The subject's less affected arm was placed in a sling for a period of six hours during the intervention phases. The duration of the CIMT was 10 working days, followed by a two-week withdrawal phase. This sequence was repeated once. The subject was engaged in play and self-care activities in his home environment during the intervention phases. The Pediatric Evaluation of Disability Inventory (PEDI) was used to assess the subject six times: at the start; before and after interventions; and after the last withdrawal phase. The minimal clinically important difference (MCID) was calculated between the first and last assessments to determine the effectiveness of the CIMT. The critical 11 points difference was reached in the PEDI self-care domain for functional skills (such as dressing and washing) and in the social functioning domain for caregiver assistance (indicating that the caregivers were giving less assistance with regards to participation in household chores, communication and play ability).

Key words: Cerebral palsy; Constraint-Induced Movement Therapy; Functional skills; Pediatric Evaluation of Disability Inventory (PEDI); Self-care


 

 

“Full text available only in PDF format”

 

 

References

1. Morris C. Definition and classification of cerebral palsy: a historical perspective. Developmental Medicine and Child Neurology, 2007; 49(Supplement): 3-7.         [ Links ]

2. Baxter P Foreword. Developmental Medicine and Child Neurology, 2007; 49(Supplement): 2-2.         [ Links ]

3. Bax M, Goldstein M, Rosenbaum P Leviton A, Paneth N, Dan B, Jacobsson B, Damiano D. Proposed definition and classification of cerebral palsy, April 2005. Developmental Medicine and Child Neurology, 2005; 47(8): 571-6.         [ Links ]

4. Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D, Dan B, Jacobsson B. A report: the definition and classification of cerebral palsy April 2006. Developmental Medicine and Child Neurology, 2007; 49(Supplement): 8-14.         [ Links ] [Online] <http://proquest. umi.com.ez.sun.ac.za/pqdlink?index=4&sid=1&srchmode> (29 Aug 2009)

5. Goldstein M. Therapeutic possibilities: Research overview and commentary. In Scrutton D, Damiano D, Mayston M, editors. Management of motor disorders of children with cerebral palsy. 2nd ed. London: Mac Keith Press; 2004:83-192.         [ Links ]

6. Liepert J, Bauder H, Miltner W, Taub E, Weiler C. Treatment induced cortical reorga-nisation after stroke in humans. Stroke, 2000; 3 1 (6): 1210-6.         [ Links ] [Online] <http://ovidsp.tx.ovid.com.ez.sun.ac.za/spb/ovidweb.cgi?QS2=434f4ela73d3>(18 Jul 2008)

7. Taub E. "Constraint-induced movement therapy." UAB Insight (University of Alabama at Birmingham). 2007; Spring. <http://www.uabhealth.org/l6212/> (18 Jul 2008)        [ Links ]

8. Taub, E., Ramey, S. L., DeLuca, S., & Echols, K. (2004). Efficacy of constraint-induced movement therapy for children with cerebral palsy with asymmetric motor impairment. Pediatrics, 113, 305-312.         [ Links ]

9. Blech J. Selbstheilung im Denkorgan. Der Spiegel. 2008; 10:162-4. German.         [ Links ]

10. Charles JR, Gordon AM. Repeated course of constraint-induced movement therapy results in further improvement. Developmental Medicine and Child Neurology, 2007; 49(10):7 70-4.         [ Links ] [Online] < http://proquest.umi.com.ez.sun.ac.za/pqdweb?index=4&did=l40779103l> (18 Jul 2008)

11. Charles J, Lavinder G, Gordon AM. Effect of constraint-induced therapy on hand function in children with hemiplegic cerebral palsy. Pediatric Physical Therapy, 2001; 13(2):68-76.         [ Links ] [Online] <http://ovidsp.tx.ovid.com.ez.sun.ac.za/spb/ovidweb.cgi?QS2=434f4e1a73> (8 Aug 2008)

12. Eliasson A-C, Krumlinde-Sundholm L, Shaw K, Wang C. Effects of / constraint-induced movement therapy in a young child with hemiplegic cerebral palsy: an adapted model. Developmental Medicine and Child Neurology, 2005; 47(4); 266-276.         [ Links ] [Online] Available from: /progquest. (8 August 2008)

13. Naylor CE, Bower E. Modified constraint-induced movement therapy for young children with hemiplegic cerebral palsy: a pilot study. Developmental Medicine and Child Neurology, 2005; 47: 365-369.         [ Links ] [Online] <http://proquest.umi.com.ez.sun.ac.za/pqdweb?index=l3&did> (8 Aug 2008)

14. Dickerson AE, Brown LE. Pediatric constraint-induced movement therapy in a young child with minimal active arm movement. American Journal of Occupational Therapy, 2007; 61(5): 563-753        [ Links ]

15. Taub E, Uswatte G, Pidikiti R. Constraint-Induced Movement Therapy: A new family of techniques with broad application. Journal of Rehabilitation Research and Development, 1999 Jul; 36(3):237-52.         [ Links ] [Online] <http://proquest.umi.com.ez.sun.ac.za/pqdweb?RQT=572&TS=1254999385> (6 Oct 2009)

16. Charles J, Gordon AM. A critical review of Constraint-Induced Movement Therapy and forced use in children with hemiplegia. Neural Plasticity. 2005; 12(2-3):245-6l.         [ Links ] [Online] <http://find.galegroup.com.ez.sun.ac.za/itx/retrieve.do?contentSet> (24 March 2009).

17. Sutcliffe LT, Gaetz WC, Logan WJ, Cheyne DO, Fehlings DL. Cortical reorganization after modified constraint-induced movement therapy in pediatric hemiplegic cerebral palsy. Journal of Child Neurology, 2007 Nov; 22(11): 1281 -7.         [ Links ] [Online] <http://jcn.sagepub.com.ez.sun.ac.za/cgi/reprint/22/ll/128l>(27 Aug 2009)

18. DeLuca SC, Echols K, Ramey S, Taub E. Pediatric constraint-induced movement therapy for a young child with cerebral palsy: two episodes of care. Physical Therapy, 2003 Nov; 83(11):1003-13.         [ Links ]

19. Karman N, Maryles J, Baker RW, Simpser E, Berger-Gross P. Constraint-induced movement therapy for hemiplegic children with acquired brain injuries. Journal of Head Trauma and Rehabilitation,         [ Links ] [Internet]. 2003; 18(3):259-67. [Online] http://ovidsp.tx.ovid.com.ez.sun.ac.za/spb/ovidweb.cgi?&S=IBLJFPJJJBDDPCAANCFL> (7 October 2007)

20. Fergus A, Buckler J, Farrell J, Isley M, McFarland M, Riley B. Constraint-Induced Movement Therapy for a child with hemiparesis: a case report. Pediatric Physical Therapy, 2008; 20(3):271-83.         [ Links ] [Online] http://ovidsp.tx.ovid.com.ez.sun.ac.za/spa/ovidweb.cgi?WebLinkFrameset=l&S=AGMC. (24 March 2009)

21. Martin A, Burtner PA, Poole J, Philips J. Case Report: ICF-Level Changes in a Preschooler after Constraint-Induced Movement Therapy. American Journal of Occupational Therapy, 2008; 62(3): 282-9.         [ Links ] [Online] http://proquest.umi.com/pqdweb?did=l5l5027211&sid=2&Fmt=3&clientId. (25 August 2009)

22. Crocker MD, McKay-Lyons M, McDonnel E. Forced use of the upper extremity in cerebral palsy: a single-case design. American Journal of Occupational Therapy, 1997; 5l(10):824-33.         [ Links ]

23. Charles JR Wolf SL, Schneider JA, Gordon AM. Efficacy of a child-friendly form of constraint-induced movement therapy in hemiplegic cerebral palsy: a randomized control trial. Developmental Medicine and Child Neurology, 2006; 48(8): 635-42.         [ Links ] [Online] http://proquest.umi.com.ez.sun.ac.za/pqdweb?index=9&did=109446849l&SrchMode=3. (10 August 2009)

24. DeLuca SC, Echols K, Law CR, Ramey S. Intensive Pediatric Constraint-Induced Therapy for children with cerebral palsy: randomized, controlled, cross over trial. Journal of Child Neurology, 2006; 21(11):931 -8.         [ Links ] [Online] http://web.ebscohost.com.ez.sun.ac.za/ehost/detail?vid=3&hid=108&sid=fd50099d. (12 August 2008)

25. Strydom H. Single-system design. In: De Vos AS, Strydom H, Fouché CB, Delport CSL, editors. Research at grassroots. 3rd ed. Pretoria: Van Schaik Publishers; 2005:144-58.         [ Links ]

26. Shevell, M. I. The terms diplegia and quadriplegia should not be abandoned. Developmental Medicine and Child Neurology, 2012; 52: 508-509        [ Links ]

27. Palisano R, Rosenbaum P, Bartlett D Livingston M. "Gross Motor Function Classification System Expanded and Revised." CanChild Centre for Childhood Disability Research Institute for Applied Health Sciences, McMaster Universtiy, Hamilton, Ontario http://motorgrowth.canchild.ca/en/GMFCS/expandedandrevised.asp (25 February 2012)        [ Links ]

28. Haley SM, Coster WJ, Ludlow LH, Haltiwanger JT, Andrellos PJ. Pediatric Evaluation of Disability Inventory (PEDI). San Antonio (TX): The Psychological Corporation; 1992.         [ Links ]

29. Elfant I, Asher MS. Occupational therapy assessment tools: An annotated index. 2nd ed. Bethesta, MA: American Occupational Therapy Association. 1996.         [ Links ]

30. Nichols DS, Case-Smith J. Reliability and validity of the Pe-diatric Evaluation of Disability Inventory. Pediatric Physical Therapy,         [ Links ] [Internet]. 1996 [cited 2009 Jul 7]; 8:15-24. Available from: http://ovidsp.tx.ovid.com.ez.sun.ac.za/spa/ovidweb.cgi?&S=KHODFPBKGEDDLKHENC.

31. Feldman AB, Haley SM, Coryell J. Concurrent and construct validity of the Pediatric Evaluation of Disability Inventory. Physical Therapy, 1990 Oct; 70(10):602-11. <http://find.galegroup.com.ez.sun.ac.za/itx/paginate.do?qrySerId>(8 Jul 2009)        [ Links ]

32. Reid TD, Boschen K, Wright V Critique of the Pediatric Evaluation of Disability Inventory (PEDI). Physical and Occupational Therapy in Pediatrics, 1994 Apr; l3(4):57-87. <http://www.informaworld.com.ez.sun.ac.za/smpp/content~db=all~content>(8 Jul 2009)        [ Links ]

33. Ziviani J, Ottenbacher KJ, Shephard K, Foreman S, Astbury W, Ireland P Concurrent validity of the Functional Independence Measure for Children (WeeFIM()) and the Pediatric Evaluation of Disabilities Inventory in children with developmental disabilities and acquired brain injuries. Physical and Occupational Therapy in Pediatrics, 2002; 21(2):91-101. <http://pdfserve.informaworld.com.ez.sun.ac.za/846879_792625948>(l9 Oct 2009)        [ Links ]

34. Ketelaar M, Dahmen A, Vermeer JA, Helders PJM. Functional motor abilities of children with cerebral palsy: a systematic review of assessment measures. Clinical Rehabilitation, 1998 Oct; 12(5):369-80. <http://web.ebscohost.com.ez.sun.ac.za/ehost/results?vid=2> (9 Jul 2009)        [ Links ]

35. Iyer LV Haley SM, Watkins MP Dumas HM. Establishing minimally clinically important differences for scores on the Pediatric Evaluation of Disability Inventory for inpatient rehabilitation. Physical Therapy, 2003 Oct; 83(10):888-99. <http://web.ebscohost.com.ez.sun.ac.za/ehost/pdf?vid=3&hid=6&sid>(9 Jul 2009)        [ Links ]

36. Deitz JC. Single subject research. In: Kielhofner G, editor. Research in occupational Therapy. Philadelphia: FA. Davis Company; 2006:140-54.         [ Links ]

37. Shonaquip: disability training and equipment.         [ Links ] [Online] 2009 http://www.shonaquip.co.za/about.htm?sm[pl][category]=276&sm (5 Oct 2009)

38. Martin A, Burtner PA, Poole J, Philips J. Case Report: ICF-Level Changes in a Preschooler after Constraint-Induced Movement Therapy. American Journal of Occupational Therapy, 2008 May/ June; 62(3): 282-9. <http://proquest.umi.com/pqdweb?did=151502721l&sid=l&Fmt=3&clientId>(25 Aug 2009)        [ Links ]

39. Tomopoulos S, Dreyer BP, Tamis-Lemonda C, Flynn V, et al.; Books, Toys, parent-child interaction and development in young Latino children. Ambulatory Pediatrics. 2006 March/April; 6(2):72-9. <http://proquest.umi.com.ez.sun.ac.za/pqdweb?index=3&did=10l9482821>(25 Aug 2009)        [ Links ]

40. Charles J, Gordon AM. Development of hand-arm bimanual intensive training (HABIT) for improving bimanual coordination in children with hemiplegic cerebral palsy. Developmental Medicine and Child Neurolology, 2006; 48(11): 93 1-7. <http://proquest.umi.com.ez.sun.ac.za/pqdweb?index=5&did=ll6l12553l>(24 March 2009).         [ Links ]

 

 

Correspondence:
Ursula Hamer-Rohrer
uhamer@telkomsa.net