The Effect of Constraint-Induced Movement Therapy on the Rest-activity Patterns in Children with Spastic Hemiparetic Cerebral Palsy

Keywords

cerebral palsy - rest activity- patterns - actimetry - constraint- induced movement therapy - children

Introduction: Spastic hemiparetic Cerebral Palsy (CP) is the most prevalent type of CP; it is a condition that affects muscle control and function on one side of the body. Children with spastic hemiparesis experience difficulties when using their affected upper extremities in their daily lives, and one effective treatment is Constraint-Induced Movement Therapy (CIMT). The study of rest-activity patterns provides information on children's daily activities with spastic hemiparetic CP during the day and sleep.

Aim: We aim to investigate the effect of CIMT on the rest-activity patterns in children with spastic hemiparetic CP vs in a healthy group.

Methods: This nonrandomized controlled trial was conducted at the neuropediatric center. Children with spastic hemiparetic CP between 5 and 16 years participated in the study group. The healthy group was composed of children between 5 and 15 years. Changes in rest-activity patterns can be studied through nonparametric variables of actigraphy: M10 (an individual's most active 10h); L5 (an individual's least active 5h); and RA (relative amplitude of the rest-activity patterns).

Results: Forty-five children were recruited; 38 were included in the analyses; 19 had spastic hemiparetic CP (study group), their mean age was 9.31 years (±3.07), and 11 (57.8%) were boys; 19 children were from the healthy group, their mean age was 9.84 years (±2.69), and 13 (68.4%) were girls. In the study group, there was a significant increase in M10 and L5 (p < 0.001), and in the frequency and quality of movement of the affected upper extremity (p < 0.001) after CIMT. The values of M10 and L5 were significantly higher (p < 0.001) in the healthy group compared with the study group after CIMT. No differences were found between RA in the study group and the healthy group after CIMT (p = 0.157).

Conclusions: Our results demonstrated that CIMT increased the values of the M10 and L5 variables, which shows an improvement in rest-activity patterns. In summary, these non-parametric actimetry variables successfully showed that children with spastic hemiparetic CP became more active and participant in their daily life during the day as well as more efficient sleeping.

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
15 June 2023