Effectiveness of ICF-based modified constraint induced movement therapy on hand functions in children with hemiplegic cerebral palsy

Introduction: According to International Classification of Functioning, Disability and Health (ICF), children with Cerebral palsy may have considerable impairments and limitations in all levels of body structure and functioning, activity, and participation in social roles. The purpose of this study was to evaluate the efficacy of adapted constraint induced movement therapy (CIMT) on outcome measurements based on ICF levels. Materials and Methods: In a single-blinded randomized controlled trial, 28 participants who met preset inclusion and exclusion criteria were divided into two groups: CIMT and the controls. Subjects in CIMT group were provided with the intervention for 10 out of 12 consecutive days and another group received routine occupational therapy services. Independent-sample t test and paired-sample t test were used for statistical analysis of data. Results: At ICF level of body structure and function, significant differences in shoulder muscle tone and forearm and wrist passive range of motion (PROM) were found between the two studied groups. At activity and participation levels, similar differences were also indicated in dexterity, bilateral coordination, bimanual coordination and Caregiver Functional Use Survey (how well amp; how frequently) (P 0.05). Conclusion: Implementing the adapted constraint induced movement therapy protocol through a child-friendly approach was proved to improve hand functions and activities of daily living.