Effectiveness of Constraint-Induced Movement Therapy for Children With Hemiparesis Associated With Cerebral Palsy: A Systematic Review

Abstract

Abstract Importance: This systemic review synthesizes the existing literature to determine whether constraint-induced movement therapy (CIMT) is more effective than other approaches in improving upper extremity function in children diagnosed with hemiparesis associated with cerebral palsy (CP). Objective: To advance the knowledge of the effectiveness of CIMT for occupational therapy practitioners by critiquing research conducted over the past 20 yr. Data Sources: Databases used in the search were CINAHL, Health Source: Nursing/Academic Edition, PsycINFO, PubMed, Research Gate, and Google Scholar. Studies published from 2001 to 2021 were reviewed. Study Selection and Data Collection: Articles were included if (1) the primary diagnosis was hemiparesis associated with CP; (2) participants were younger than age 21 yr; (3) constraint-induced therapy, CIMT, or other modified forms of CIMT were offered as an intervention; and (4) there was at least one group in the study. Findings: Forty studies were included in the analysis. The results demonstrate that CIMT produces improved affected upper extremity function when compared with general rehabilitation. However, there were no differences in outcomes when bimanual approaches were compared with CIMT. Conclusions and Relevance: The data support that CIMT is a beneficial and effective treatment when used to improve the upper extremity function of children with hemiparesis associated with CP. However, more Level 1b studies are needed to compare CIMT with bimanual therapy to determine which one is most effective and under which conditions. What This Article Adds: This systematic review demonstrates that CIMT is an effective intervention when compared with other therapeutic approaches. This intervention can be used by occupational therapy practitioners who work with children diagnosed with hemiparesis associated with CP.