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

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).

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