However, little was known about whether the outcome of therapy was directly linked to the dosage of therapy or method of constraint.
To find this, a new study called The Children with Hemiparesis Arm-and-hand Movement Project (CHAMP) compared different dosage levels of the same type of CIMT intervention for children with similar movement disorders.
Researchers focused on children with hemiparetic cerebral palsy (HCP), the most common childhood neuromotor disorder that affects one to four children per 1,000 in the United States.
About 40% of these children will develop hemiparesis – impaired voluntary control on one side of the body, according to the Centers for Disease Control and Prevention.
The study group included 118 children with HCP, two- to eight years old, at three sites. CHAMP randomized and assigned children to different CIMT treatment groups that varied in their dosage level (30 versus 60 hours in four weeks) and the type of constraint used (cast versus splint).
These treatment groups were compared with a Usual and Customary Treatment group – that later was offered a form of CIMT as an ethical option for study participation.
They found that the higher intensity therapy sessions – three hours a day, five days a week for four weeks – significantly improved upper arm and hand abilities while a lower dosage of 30 hours per month (2.5-hour sessions, three days a week for four weeks) produced fewer gains.
The children’s early improvements continued for at least six months after higher-intensity CIMT. Those benefits were delivered to more than 500 children.
“The therapists are trained to ensure each child has many successes in every therapy session,” said DeLuca, who is an associate professor at the research institute and in pediatrics and neuroscience at Virginia Tech.
The study also shows that that Usual and Customary Treatment benefited children more than it did in the past and the higher CIMT intensity is not stressful for the parents as the children quickly adapted to it.
These findings could transform the clinical understanding of the high potential these children have for future growth and far-reaching impacts on the treatment of children’s movement disorders.
Source: Medindia
