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From: CPNUES
Category: General
Date: 08 Jul 2001
Time: 03:03:27
Remote Name: 24.177.100.223
Constraint therapy is binding or holding down the non-involved arm to make the involved arm work more. It is used with a diagnosis of hemiplegia (half of the body). Most of the articles on this type of technique are based on stroke or head injury patients in adults. I am not sure that the findings can be applied to CP as the deficits are very different. I have heard of very few therapists and clinics that are advocating the technique completely for use in children. The controversy is the perceived extreme measure of binding down or putting a sling on the "good" arm for much of the day for extended periods. True "forced use" entails constraining, which may contribute to frustration in the child. You'll have to see where in that balance your child fits and if the pros outweigh the cons. You'll probably encounter people either very for or very against it, so you will need to make the decision. So, take all advice in the context of your own child and how you think they work best. I would certainly recommend finding only a structured program so that all aspects of the treatment, including behavioral issues, will be addressed Anecdotally, my only experience with an example is when I had an 8 year old pt with hemiplegia break her non-involved arm and it was casted. She did gain some small skills in her involved arm, but after the cast came off, she reverted to her usual patterns, as they were so much more efficient in everyday life. Keep in mind even traditional therapy that encourages "use two hands etc" is in some way "forcing use" even if it is just convincing a child a two handed task is fun. I never did true restraining, more just intensive structured use of the involved arm. For example, leaning on the non- involved arm so the involved arm is more accessible. We tend to favor a more traditional NDT approach with encouraged involved side and bimanual tasks. Here are some references about constraint therapy. They are quite dense and scientific but all that I have seen. Both articles reference adults with brain injury, not CP. I would try finding them in your local medical school library or have a local library order them for you. They'll usually do it for a small fee. Let me know if you have problems finding them. Good luck and please let us know what you end up trying and how it worked out. Also, we'd love to hear from clinicians and families familiar with the technique. Articles: Forced Use of Hemiplegic Upper Extremities to Reverse the Learned Nonuse among Chronic Stroke and Head Injured Patients: Experimental Neurology 104:125-132 (1989) Wolf S, Lecraw D, Barton L. & Jann B
Constraint Induced Movement Techniques to Facilitate Upper Extremity Use in Stroke Patients: Topics in Stroke Rehabilitation 3(4):38-61 (1997) Taub E, Wolf S
From: alphasyl@aol.com
Category: Constraints
Date: 23 Mar 2003
Time: 01:57:13
Remote Name: 152.163.188.72
I am an occupational therapy student at York College. I am doing a poster presentation about constaint-induced therapy and the pediatric population. I would appreciate a lead on any articles regarding this topic, since it is of paramount importance that my poster is based upon "evidence-based practice". I am looking for leads regarding research articles that discuss the pros and cons of this type of treatment with this population. If anyone could answer me as soon as possible I would very much appreciate it.
From: ..
Category: General
Date: 03 Sep 2005
Time: 22:58:49
Remote Name: 24.121.103.237
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Category:
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Time: 13:41:51
Remote Name: 62.101.104.141
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From: Texas
Category: Constraints
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Time: 12:01:43
Remote Name: 66.8.94.74
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From: Russia
Category: General
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<option>Constraints
<option>Handwriting
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Date: 29 Jan 2007
Time: 08:21:00
Remote Name: 85.216.135.85
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