The Children's Hospital Physical Therapy and Occupational Therapy Department is pleased to offer Pediatric Constraint-Induced Movement therapy, otherwise known as CI therapy, in our outpatient facility. In collaboration with Dr. Edward Taub, the Scientific Director of our program and originator of CI therapy, occupational therapists who have received extensive training in Pediatric CI therapy are currently conducting our program. CI therapy, originally applied in the adult stroke population, has been applied to the treatment of children and researched for several years in the pediatric population.
What is Pediatric Constraint-Induced Movement Therapy?
Constraint-Induced Movement therapy, or CI therapy, is a family of treatments that teach the brain to "rewire" itself following a major injury such as stroke or head injury. This is based on research by Edward Taub, Ph.D. and collaborators at the University of Alabama at Birmingham that showed that patients can "learn" to improve the ability to move the weaker parts of their bodies and therefore not rely primarily on the stronger extremities. These therapies have significantly improved quality of movement and substantially increased the amount of use of the more-affected extremities in the activities of daily living for a large majority of children who have received the treatment. It is the only rehabilitation technique shown to produce a marked change in brain organization and function. There is also a great deal of evidence for the clinical effectiveness of CI therapy, including an NIH-supported multi-site randomized clinical trial, which is considered to be the "gold standard" in medical fields.
What does Constraint- Induced Movement Therapy consist of?
Occupational therapists will be conducting CI Therapy in our program. Pediatric CI Therapy consists of 3 major factors: (1) the stronger arm must be completely restrained for up to 3 weeks using a lightweight fiberglass cast extending from the upper arm to the fingertips, (2) the weaker arm must be trained using shaping techniques in a play situation that is appropriate to the child's stage of development, (3) the therapy will be administered for 3-4 hours per weekday for 2 or 3 weeks, totaling 10 or15 days of treatment (depending on the severity of the symptoms). Home practice is an integral part of CI therapy. Caretakers will be given home practice activities to carry out with each child both during and after the program in order to assure optimum skill retention.
Where will the treatment take place?
All testing and treatment will take place at The Children's Hospital Park Place Outpatient PT/OT Department. The therapist will be treating children for 3-4 hours each weekday and will engage each child in fun new games and activities in order to elicit useful movements and motor skills. The treatment will include helping children with activities of daily living such as eating, self-care and outdoor play. This will allow the child to put into practice the new skills that he/she will acquire and help them gain confidence and independence in a variety of situations. An important part of CI therapy is regular follow-up with caretakers to assess how well and how often a child is using the skills he/she attained during the program. This part of the therapy helps caretakers to "stay on track" in their new understand of encouraging use of their child's affected arm and hand. This follow-up is done over the phone and takes about 30 minutes for each session.
What is the cost of the Constraint-Induced Movement Therapy program?
Because this therapy is provided by licensed occupational therapists and delivered through our outpatient hospital setting, Children's Hospital will bill insurance for reimbursement. Parents/guardians will be responsible for paying any amount that insurance does not cover.
Has Constraint-Induced Movement Therapy been successful for others?
Constraint-Induced Movement Therapy has benefited over 400 adults in Birmingham who had a stroke more than one year before the beginning of treatment, and several thousand others in the U.S.A., Europe, and a number of other countries in the world. Pediatric CI therapy has benefited many children with a diagnosis of:
- cerebral palsy
- traumatic brain injury
- other impairments affecting one arm or hand
For further information and/or to schedule Pediatric CI therapy, please contact:
Angi Griffin, MA, OT/L, Pediatric CI therapy Program Manager