Neuropediatrics 2011; 42 - P035
DOI: 10.1055/s-0031-1274007

Therapy of Hemiparesis in children and adolescents – a 5 years experience

M Hessenauer 1, J Schäfer 2, C Adler 1, A Laage-Gaupp 2, U Michaelis 3, U Breuer 2, AS Schröder 2, C Raabe 4, S Ney 4, M Lippert 2, M Staudt 1, V Mall 3, S Berweck 1
  • 1Schön Klinik Vogtareuth, Klinik für Neuropädiatrie und neurologische Rehabilitation, Vogtareuth, Germany
  • 2Dr. von Haunersches Kinderspital, Ludwig-Maximilians-Universität München, Klinik für Neuropädiatrie und Sozialpädiatrie, München, Germany
  • 3Zentrum für Kinder-und Jugendmedizin, Klinik II: Neuropädiatrie und Muskelerkrankungen, Freiburg, Germany
  • 4Klinik für Kinderheilkunde und Jugendmedizin, Universität Tübingen, Tübingen, Germany

Objective: CIMT developed as somewhat a „gold-standard„ for children with hemiparesis during the last years. Antidromic the therapeutic approach in four centres for hemiparesis in children and adolescents diversified from a well defined protocol to an individual treatment decision.

Methods: Quantitative and qualitative analysis of five „intensive therapy camps„ with n=50 children with congemital hemiparesis. Therapy methods: constraint 2–10 hours/day, Shaping 1–2 hours/day, bimanal functional training, bimanual ADL based therapy, therapy in groups, developing of strategies (not necessarily in conjunction with functional improvements), casting, botulinum toxin, strength training, orthotics

Results:

  • The corticospinal reorganization influences the method of therapy

  • Therapy goal and task analysis define on which therapy methods is taken emphasis on.

  • Group acticities are an important factor for treatment success

  • Induced changes are relevant for everyday life.

  • The choice of therapy may be modified or changed during the course of an intensive therapy camp.

  • Sensitive to change are Goal Attainment Scaling, Canadian occupational performance measure, Assisting Hand Assessment, Jebson Taylor Test, Range of motion (active, passive).

Discussion: CIMT is an effective approach, but should not limit the scope of available therapy approaches, which have to be chosen according to task analysis.