Pediatric CI Therapy Research

NOTICE: Due to the overwhelming volume of response to this study, the best way to get in touch with us is to complete the Pediatric Patient Information Form provided and we will respond to you as the enrollment progresses. Click here to download the Pediatric Patient Information Form, and mail the completed form to the address listed on the form.

Welcome to the Children's Hospital Physical Therapy and Occupational Therapy Department. We are pleased to be conducting research in the area of Pediatric Constraint-Induced Movement Therapy, an exciting new therapy that has shown to have significant gains in children with neuromotor disorders. This is a project of the University of Alabama at Birmingham being conducted in cooperation with The Children's Hospital. The therapy was originated by Dr. Edward Taub and colleagues. Dr. Taub is directing the current work. The original therapy was developed for adult patients who had a stroke. The therapy for children was derived from the work with adults.

We are currently assessing interest in Constraint-Induced Movement Therapy among parents whose children have undergone hemispherectomy surgery. Interested parents should complete the Pediatric Patient Information Form and mail it in as soon as possible.

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 patients who have received the treatment. It is the only rehabilitation technique shown to produce a marked change in brain organization and function.

What does Constraint- Induced Movement Therapy consist of?
For this particular study an occupational therapist will be conducting the therapy. It consists of 3 major factors: (1) the stronger arm must be completely restrained for 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 6 hours per weekday for 3 weeks, totaling 15 days of treatment. The therapists will assign home practice to be carried out by the guardian over the weekend.

Where will the treatment take place?
Testing is provided at The Children's Hospital and will take a full day to complete. Daily therapy will take place in the child's most natural environment, such as the home or for those coming from out of town in their hotel. The therapist will be in the home for 6 hours per weekday and will engage your child in fun new games and activities in order to elicit useful movements and motor skills. The treatment will also take place on weekly "outings" such as the park, zoo, and fast food restaurants. 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. After the treatment is completed the child will need to spend a day at Children's Hospital to complete testing. Your child will then be asked to participate in periodic follow-ups to check their progress and gains over time.

What is the cost of the Constraint-Induced Movement Therapy research study?
There will be no costs to you for participation in this study. All examinations and treatments associated with the project will be provided at no cost to you during the study period. We are not allowed to reimburse families for lodging or food, but have been given discounted rates at local hotels and apartments. For a complete list of accommodations please feel free to contact us.

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 abroad. Pediatric CI therapy has benefited children with a diagnosis of cerebral palsy, hemisphrectomy, traumatic brain injury, and hydrocephaly. While the amount of individual improvement varied, most of the participants have shown a marked increase in the functional ability of the affected arm.

Who is eligible to participate in Pediatric CI Therapy research?
For this particular study we are looking for children ages 2 to 6 years old with hemiplegia due to cerebral palsy. For future research we will apply this therapy to other populations and diagnoses. If your child has a neuromotor disability that results in one extremity being significantly weaker than the other, then they may be eligible for future studies.

Pediatric CI Therapy Research Group:
Angi Griffin, MA, OTR/L, Coordinator of PT/OT Outpatient Services, CI Therapy Supervisor
Jennifer Nick, MSOTR/L, Pediatric CI Therapist
Kristin Gammons, MSOTR/L, Pediatric CI Therapist
Edward Taub, Ph.D., Director of CI Therapy Research Group
Charles R. Law, M.D., Associate Professor, Medical Director of the Department of Pediatric Rehabilitatoin Medicine