Poster #102 - Effects of a camp-based modified Constraint Induced Movement Therapy (mCIMT) program on gross and fine motor function in children with hemiplegia

• In Event: Poster Session 01

Abstract

Background/Objectives: Children with hemiplegia have significant difficulties in using their affected upper extremity for daily function including self-care, school-work, and leisure activities. Modified constraint-induced movement therapy (mCIMT) is an evidence-based approach that has found to be effective in improving affected arm use in children with hemiplegia; however, evidence on optimal dosing required to produce meaningful, real-world improvements in arm function is still lacking. The present study assessed the effects of a mCIMT program delivered during an intensive 3-week summer camp on motor function and control on the affected side in children with hemiplegia.
Study Design: Quasi-experimental, single group design.
Study Participants: Ten children with hemiplegia participated in a 3-week summer camp based on principles of mCIMT. Children with a clinical presentation of hemiplegia due to a variety of causes including cerebral palsy, infantile stroke, and hydrocephalus were included. Children were required to obtain clearance from their physician prior to participation in the camp. Children were excluded if they had only lower limb impairments or comorbidities that limited their ability to participate in camp activities.
Materials & Methods: Children participated in the training for 6 hours/day, 5 days/week, for 3 weeks during the camp. Children wore a cast on their unaffected/strong side for the duration of the camp day. Training activities involved a mix of gross and fine motor activities that provided children systematic, repetitive, and intensive practice aimed at improving reaching, grasping, and release skills. Activities were designed as interactive games based on different themes such as popular animated movies, sport themes, and different professions to increase children’s engagement. Children also practiced self-care skills including eating, dressing, and using the restroom during the camp day with their unaffected arm casted. We used a custom-designed test that included 11 functional tasks requiring reach, grasp, in-hand manipulation, and release using the affected upper extremity. The test was videotaped once every week at camp. Video data were scored to assess task success, movement control and modulation, need for assistance, presence of compensatory movements, time to completion, quality of reach, grasp, in-hand manipulation, and release, as well as number of attempts.
Expected Results: We are presently analyzing data collected from the mCIMT camp. We hypothesize that across training weeks children will increase task success, improve muscle strength and movement control of the affected arm during test tasks, will require lesser tester assistance, fewer attempts, and lesser overall time to complete tasks successfully. Their overall scores on test tasks will increase from early to late training weeks.
Conclusions/Significance: If our hypotheses are upheld, we will provide evidence in support of intensive camp-based training programs based on principles of mCIMT to improve use of the affected arm for daily function in children with hemiplegia. In the future, we will assess the efficacy of shorter bursts of mCIMT-based training programs on arm function in children with hemiplegia.

Authors

• Sudha M Srinivasan, University of Connecticut
  Presenting Author

• Vaishnavi Sandeep Shahane, University of Connecticut

• Catherine Harrick

• neil komma

• Lianna Hagen

• Jamie Cheung

• Destiny Cruz

• Samantha Gilmore

• Amanda Soucy

• Cindy Jackson