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:
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The corticospinal reorganization influences the method of therapy
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Therapy goal and task analysis define on which therapy methods is taken emphasis on.
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Group acticities are an important factor for treatment success
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Induced changes are relevant for everyday life.
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The choice of therapy may be modified or changed during the course of an intensive
therapy camp.
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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.
