Modified-constraint movement induced therapy versus neuro-developmental therapy on reaching capacity in children with hemiplegic cerebral palsy

Radwa S Abdul-Rahman; Nadia L Radwan; Bassam A El-Nassag; Wafaa Mahmoud Amin; Mostafa S Ali

doi:10.1002/pri.2069

Modified-constraint movement induced therapy versus neuro-developmental therapy on reaching capacity in children with hemiplegic cerebral palsy

Physiother Res Int. 2024 Jan;29(1):e2069. doi: 10.1002/pri.2069.

Authors

Radwa S Abdul-Rahman^{1

2}, Nadia L Radwan^{3

4}, Bassam A El-Nassag⁵, Wafaa Mahmoud Amin^{6

7}, Mostafa S Ali^{1

8}

Affiliations

¹ Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Cairo, Egypt.
² Department of Physical Therapy for Pediatrics and Pediatrics Surgery, College of Physical Therapy, Badr University in Cairo, Cairo, Egypt.
³ Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Cairo, Egypt.
⁴ Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Saudi Arabia, Kingdom of Saudi Arabia.
⁵ Department of Physical Therapy for Neurology, Cairo University, Cairo, Egypt.
⁶ Basic Sciences for Physical Therapy, Faculty of Physical Therapy, Cairo University, Cairo, Egypt.
⁷ Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, Saudi Arabia, Kingdom of Saudi Arabia.
⁸ Department of physical therapy for Pediatrics, Faculty of Physical Therapy, October 6 University, 6 October City, Giza, Egypt.

PMID: 38284468
DOI: 10.1002/pri.2069

Abstract

Background and objective: Upper extremity impairment is one of the complications in hemiplegic children. The purpose of modified constraint-induced movement therapy (mCIMT) is to improve the function of impaired arms and hands in these children. This study compared the efficacy of mCIMT and the approach of neurodevelopmental therapy (NDT) on reaching capacity in children with spastic hemiplegia.

Methods: Fifty-two spastic hemiplegic children ranging in age from four to 6 years were selected for this study from an outpatient clinic and biomechanical lab (Prince Sattam bin Abdulaziz University, KSA). They were randomly divided into two experimental groups: group I received NDT and group II received mCIMT for the involved upper limb and restriction of the uninvolved arm movements for 12 weeks (three times per week). Both groups received a conventional exercise program in addition to experimental one. Active elbow extension range of motion and three-dimensional motion analysis of the reaching task were measured before and after 3 months of treatment.

Results: Significant enhancement in all pre-treatment and post-treatment outcomes was observed in both groups by a two-way mixed MANOVA; furthermore, Group II (mCIMT) showed the most significant improvement (elbow extension, percentage of reach to peak velocity, movement time and movement units) when comparing the post-treatment outcomes between the two groups (p < 0.001).

Implication for physiotherapy practice: Addition of mCIMT to a conventional exercise was superior to adding NDT exercise therapy in promoting the performance of reaching pattern in hemiplegic children.

Keywords: constraint-induced movement therapy; hemiplegic cerebral palsy; neuro-developmental therapy; reaching.

Publication types

Randomized Controlled Trial

MeSH terms

Cerebral Palsy* / rehabilitation
Child
Child, Preschool
Exercise Therapy / methods
Hand
Hemiplegia / rehabilitation
Humans
Movement
Treatment Outcome
Upper Extremity