Gross motor outcomes in children with hemiparesis involved in a modified constraint-induced therapy program

Abstract

Constraint-Induced Therapy (CIT) has been used in pediatric rehabilitation and targets upper extremity (UE) outcomes. The purpose of this study was to measure concurrent gross motor and lower extremity functional changes using the Gross Motor Function Measure (GMFM) before and after a modified UE CIT program. The Assisting Hand Assessment (AHA) was used to evaluate upper extremity outcomes. Before-after trial design of a 19-day outpatient CIT program at Seattle Children's Hospital in Seattle, WA, USA of six ambulatory children with spastic hemiparesis between the ages of 5 and 11 years with GMFCS scores of 1. GMFM Section D (Standing) and E (Walking, Running, Jumping) and AHA scores were obtained before and after a modified CIT program. Significant differences were found between pre and post-CIT AHA and GMFM section D and E scores (p < 0.05). All children improved from baseline, yet the child with the lowest initial scores revealed the greatest improvements. Improvements in GMFM and AHA scores were noted after a modified CIT program. Such data suggests that CIT may also influence rehabilitation outcomes not only specific to the upper extremity and warrants further investigation.