Modified constraint-induced therapy for children with hemiplegic cerebral palsy: A feasibility study

Purpose: To determine the feasibility of family-focused, modified constraint-induced therapy with children with hemiplegic cerebral palsy and test study procedures in preparation for a randomized controlled trial. Design: Prospective pre-post feasibility study. Methods and procedures: Ten children (median age: 3 years 6 months) were assessed at baseline, at completion of intervention and at 6 months post-baseline. Intervention consisted of a mitt worn on the unaffected hand for 2 hours per day for 8 weeks. Targeted adjunct therapy was provided during the time the mitt was worn. Primary assessments included the Canadian Occupational Performance Measure, Goal Attainment Scaling, Assisting Hand Assessment and the Melbourne Assessment of Unilateral Upper Limb Function. Outcomes: Modified constraint-induced therapy as implemented in this study was acceptable to participants. Over the intervention period, participants experienced improvements in the performance of important daily activities as determined by the primary outcome measures. Conclusions: Modified constraint-induced therapy which targets participant-identified goals and which is family-focused warrants further investigation utilizing randomized trial methodology.