Younger Children with Cerebral Palsy Respond Better Than Older Ones to Therapist-Based Constraint-Induced Therapy at Home on Functional Outcomes and Motor Control

Abstract

ABSTRACTAims: To examine the differences in efficacy of home-based constraint-induced therapy (CIT) on functional outcomes and motor control in two age groups of children with cerebral palsy (CP). Methods: Twenty-three children with spastic unilateral CP receiving 4-week home-based CIT by a therapist were divided into younger (6–8 years; n = 11) and older (9–12 years; n = 12) groups. The home-based CIT involved intensive functional training of the more affected upper-limb while restraining the less affected upper-limb. The outcome measures were Peabody Developmental Motor Scale-2nd edition (PDMS-2) that was being used in a modified way, Functional Independence Measure for Children (WeeFIM), and reach-to-grasp kinematic parameters, including reaction time (RT), normalized movement time (MT), normalized movement units (MUs), peak velocity (PV), and maximum grip aperture (MGA). The outcome measures were assessed at baseline, 4-weeks (post-treatment), 3- and 6-months (follow-up). Results: The younger group showed greater changes in visual motor integration skills and RT at all post-tests after intervention than the older group. Groups had comparable changes on any other measures. Conclusions: Younger children with CP responded better to home-based CIT on some areas of upper-limb functions and reach-to-grasp motor control strategies than older children.