Application of short-concentration Modified Constraint-Induced Movement Therapy for Infantile Hemiplegia with functional Ability difficulties: Case study

Abstract


BACKGROUND OF THE STUDY : Infantile hemiplegia refers to brain injuries that occurs Prenatal or at Perinatal and lead to hemiplegia/ total paralysis of one side of the body, including the face, arm and leg. The main purpose of this article is to provide valuable information to Occupational therapist about the short concentration Movement therapy view point and treatment alternatives for patients with infantile hemiplegia.
OBJECTIVE : To assess the functionality of the affected upper limb in infant diagnosed with hemiplegia aged between 0 and 1 years after applying short-concentration modified Constraint-Induced Movement Therapy (mCIMT).
METHODS : Prospective case study. A M-CIMT protocol was applied for twelve weeks, with two hours of restraint per day. The study variables were quality of functional ability of the upper limb, recurrent use, participation of the affected upper limb in self-care and unstructured activities, active joint position, hand grasp–release action, hand grasp strength, supination and extension elbow movements. Four measurements were performed, using to measure the functional ability assessment based on Functional Status Score (FSS).
RESULTS : The subject was composed of infant with moderate manual functional ability. Statistically significant differences were detected in all the studied variables (p < 0.021), between the pre-treatment and post–treatment results (2–Weeks), except for upper limb dressing, putting on lower body dressing. In the 8-12 week, the changes were statistically extremely significant, except for protective extension, grasp strength, grasp–release and all functional variables (level of functionality and participation of the patient’s upper limbs) in the FSS Evaluation p < 0.0011. The greatest increase occurred in spontaneous use from pre assessment to post Assessment (p = 0.01), reaching 88.87% active participation in bimanual sensory tasks. The quality of movement of the upper limb exhibited a significant value due to the increase in dissociated movements and hand grasp (p = 0.01).
CONCLUSION : A short-concentration (50 hours) of M-CIMT increased the functionality of infant diagnosed with hemiplegia between birth - 1 years of age with moderate manual ability.

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