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Constraint Induced Movement Therapy in Paediatrics

Children and infants as young as three months of age can benefit from modified CIMT treatment.  Perinatal stroke and brachial plexus injury are often the reasons parents seek CIMT therapy for young children, and generally speaking, the earlier it is started – the better. We all know that children develop habits very quickly and the preferred use of one arm over the other is no different.

CIMT is an approach used to improve movement and function in the arm and hand following stroke, brain injury, brachial plexus injury and other neurological conditions.  There is a substantial body of research supporting the effectiveness of CIMT and it is considered “best practice” when there is a signficant weakness on one side of the body compared to the other.

When one arm is stronger and more functional than the other, it is natural to use mostly this side because movement is faster and easier.  But by activating mostly the stronger limb, the weaker one continues to weaken even further, and the brain becomes less attuned to the weaker side.  This deterioration due to lack of use, rather than because of the initial injury, is called Developmental Disregard and can be changed.

CIMT uses the approach of constraining the stronger limb in order to promote the use of the weaker one.  Function is improved through frequent repetition of carefully graded tasks that ensure success and the intrinsic motivation that this brings to use the weaker limb even more.  Muscles are strengthened, but more importantly, neuro plasticity enables the brain to be “re-wired” to increase the use of the weaker limb.  Protocols are short (2-3 weeks) and condensed to make them manageable, while still ensuring sufficient practice to promote change.

Our paediatric therapists at Action Potential Rehabilitation are well versed in the CIMT approach and the modified protocols for younger children and babies.  Your physiotherapist will develop an individualized program of exercises and activities and will help you determine which form of restraint would be best suited for our child, depending on their needs and developmental stage.  Your therapist will see you and your child regularly and make changes as your child progresses.