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Pediatric CIMT for children with C.P. or stroke

CI Therapy, also known as Constraint-Induced Therapy or Constraint-Induced Movement Therapy, is an innovative, research supported treatment intervention consisting of families of rehabilitation techniques that assist individuals in increasing functional use of a hemiplegic arm. This therapy has been researched in the adult population for over 25 years with excellent results.

Therapists and scientists modified the adult protocol and studied the feasibility with infants, toddlers, pre-school aged and school aged children. Objective and subjective measures demonstrated meaningful gains that were maintained past the program completion. CI Therapy is considered to be the most effective intervention for the hemiplegic extremity for both adults and children.

What is CIMT all about?

Dr. Edward Taub, the founder of CI Therapy, discovered that by restraining the stronger arm and intensely training the weaker arm, the brain begins to rewire itself to improve the overall functional use of the weaker arm. Essentially, the CI Therapy program is a boot camp for the client’s affected arm and a vacation for the unaffected arm. Our clinicians fabricate a removable cast for the child on the first day. Through various play and self-care activities, the child is encouraged to move the weaker extremity while the stronger extremity is placed in the cast. Children usually adjust quickly to wearing a cast and tolerate it well.

How is this different from regular therapy?

This method is different from traditional therapy in that the patient’s less affected arm is restrained for 90% of the patient’s waking hours, resulting in a highly concentrated program to re-train the affected arm. During traditional treatment approaches, therapists may see the client for only 1 to 5 hours a week due to limitations of insurance coverage, and a client may have only 10 to 20 visits per year. During the pediatric CIMT program, the therapist is with the client for 3 hours a day for 2 to 3 weeks, optimizing opportunities for neuroplastic changes in the brain.

Interesting. What else?

At the start of the program perform an in-depth evaluation and conduct a parent-interview to get to know the child better. Our goal is always to create an individual treatment plan for each family and child that allows for carry over to the child’s home environment. The parent or family is encouraged to attend or participate in the treatment for best results. Our clinicians use a positive feedback system to immediately reinforce any movement to make the treatment motivating and fun. By repeating various movements during different play activities, refinement of movement will naturally occur.

What does a typical treatment day look like?

Here are some examples of what a treatment day might look like:

  • Review of home program

  • Weightbearing activity during floor play

  • Eating snacks

  • Coloring, building with blocks, playing with a ball

  • Sensory activities (water play for example)

  • Outside scavenger hunt

  • Playing dress up

All activities will be chosen based on the child’s liking to promote age-appropriate development for play, school and self-care tasks.

The Neuro Hub therapists were trained in the original treatment protocol by Dr. Taub and his highly skilled researchers, clinicians, and professors at the University of Alabama.

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