Affiliations: Department of Occupational Therapy, The University of
Alabama, Birmingham, AL, USA | Occupational Therapy Division, Ohio State University,
Columbus, OH, USA | Department of Pediatrics, The University of Virginia,
Charlottesville, VA, USA | Virginia Tech Carilion Research Institute Virginia
Tech, Roanoke, VA, USA
Note: [] Corresponding author: Stephanie DeLuca, 347 School of Health
Professions, UAB, 1530 3rd Avenue South, Birmingham, AL 35294, USA. Fax: +1 205
975 2380; E-mail: sdeluca@uab.edu
Abstract: Objective: To compare effects of 2 dosage levels of
constraint-induced movement therapy (CIMT) for children with hemiplegic
cerebral palsy (CP). We hypothesized that high-dosage CIMT would produce larger
benefits than moderate-dosage. Methods: Three sites enrolled a total of 18 children (6 children per
site from 3–6 years) with unilateral CP. Children were randomly assigned
to CIMT for 21 days for either 6 hours/day (high-dosage=126 hours) or 3
hours/day (moderate-dosage=63 hours); both groups wore a long-arm cast.
Evaluators (blind to dosage) assessed children 1-week prior, then 1-week and
1-month after treatment with the Assisting Hand Assessment (AHA), The Quality
of Upper Extremity Skills Test (QUEST) Dissociated Movement and Grasp sections,
the Shriners Hospital Upper Extremity Evaluation (SHUEE), and the Pediatric
Motor Activity Log (PMAL). Results: All children responded well to casting and received the
full intended dosage. Both groups showed statistically significant gains on the
AHA, QUEST, SHUEE, and PMAL. Effect sizes ranged from 0.36–0.79. Overall,
both groups showed comparable improvements at 1-week and 1-month
post-treatment. Conclusions: Pediatric CIMT at both moderate and high dosages
produced positive effects across multiple reliable, valid outcome measures. The
findings refuted the hypothesis of differential dosage benefits. Future
research should address long-term effects, enroll larger and more diverse
samples, and assess lower dosages to ascertain a minimal-efficacy
threshold.
