Modified Constraint Induced Movement Therapy in Children With Obstetric Brachial Plexus Injury

March 15, 2023 updated by: Riphah International University

Effect of Modified Constraint Induced Movement Therapy on Range of Motion, Function and Disability in Children With Obstetric Brachial Plexus Injury

The aim of this study was to increase and improve the use of affected extremity in obstetric brachial plexus palsy children while restricting the use of less affected arm and the purpose was to improve the function, Range of motion and disability in affected arm of children with brachial plexus injury.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

conducted a study that included data of 19 children with Brachial Plexus Birth Injury (4.1 years) and 18 with unilateral Cerebral Palsy (4.5 years) were compared. The effects of modified constraint-induced-movement-therapy with bimanual training (54 h modified constraint-induced-movement-therapy, 18 h bimanual training, 8-10 weeks) was investigated Children with Brachial Plexus Birth Injury showed significant improvements on all outcome measures following modified constraint-induced-movement-therapy with bimanual training. These results were comparable to those observed in the group of children with unilateral Cerebral Palsy.

Comparison of the efficacy of electrotherapy and neuromuscular retraining techniques in restoring function of children with obstetric palsy The purpose of this review is to describe and compare recent research data on the efficacy of electrotherapy and neuromuscular retraining techniques in the rehabilitation of infants with OP. : Electrotherapy and neuromuscular retraining techniques are equally useful methods for treating OP.

A Single-blinded Randomized Controlled Trial 24 subacute stroke patients were randomly assigned to the experimental group or the control group (n = 12 each) to explore the Effects of Action Observation Combined with Modified Constraint-induced Movement Therapy on Upper-extremity Function of moderate Subacute Stroke Patients. Experimental group watched video clips for 10 minutes related to tasks performed during modified constraint-induced movement therapy while the control group watched videos with modified: constraint-induced movement therapy may be a beneficial rehabilitation option to improve upper-extremity function in subacute stroke patients with moderate constraint induced movement therapy has been studied in unilateral disabilities of brain injuries but modified constraint induced movement therapy had little studies in improving arm function, ROM and disability due to obstetric brachial plexus injuries in children. It can be studied in other unilateral neurological conditions as well.

For bimanual activity performance, CIMT is preferred over normal care. A longer follow-up period, more comparator therapies, and assessments of variations by participant characteristics should all be investigated in future study of different neurological conditions of brain injuries affecting upper as well as lower limb impairment.

conducted a study that evaluated the addition of constraint-induced movement therapy (CIMT) to usual care occupational therapy in children with perinatal brachial plexus injury. 22 Participants were randomized to receive either the intervention (CIMT) or control first, then cross over to receive the other one. A passive constraint cast was applied to the participants unaffected rm for 8 weeks' scale was used to assess the bimanual care of brachial plexus participants of 12 months to 5 years were included they concluded in his study that mCIMT was more effective than usual care.

A randomized double blinded clinical trail Early non-invasive brain stimulation with modified constraint-induced movement therapy for motor and functional upper limb recovery in stroke patients: adults below 8 years, at least 2 days post unihemispheric stroke event, with hemiparesis. Modified constraint-induced movement therapy plus transcranial direct-current stimulation in subacute stroke patients with hemiparesis could maximize motor and functional recovery.

2021 conducted a randomized control trial Constraint-Induced Movement Therapy for Cerebral Palsy with Children of Hemiparesis compared 2 doses and 2 constraint types of constraint-induced movement therapy (CIMT) to usual customary treatment (UCT). randomly assigned 118 2- to 8-year-olds with hemiparetic cerebral palsy to one of 5 treatments with assessments at baseline, end of treatment, and 6 months posttreatment. Primary blinded outcomes were the assisting hand assessment; Peabody Motor Development Scales results revealed high-dose CIMT produced significantly greater improvement than a moderate dose or Usual customary care.

effect of Modified constraint-induced movement therapy during hospitalization in children with perinatal brachial plexus palsy that concluded that mCIMT has a potential to promote functional gains for children with PBPP; this approach should be widely applied within routine clinical practice Constraint-Induced Movement Therapy for Children with Brain Tumors The purpose of this pilot study was to investigate the feasibility of a 3-week constraint-induced movement therapy program in 9 children with brain tumors and upper extremity hemiplegia and to describe change in extremities Findings suggest that a child with hemiplegia as a result of a brain tumor can adhere to and benefit from a CIMT program.

Therapeutic application of electrical stimulation and constraint induced movement therapy in perinatal brachial plexus injury: A case report study in infants and children with perinatal brachial plexus injury (PBPI) was conducted. Electrical stimulation:

and constraint induced movement therapy provided sequentially were effective therapy interventions.

Effect of modified constrained induced movement therapy on improving arm function in children with obstetric brachial plexus injury. They concluded that the modified constraint movement therapy was the more effective method on improving the arm function in children with OBP

Study Type

Interventional

Enrollment (Actual)

16

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
    • Punjab
      • Multān, Punjab, Pakistan, 59300
        • Bakhtawar Amin Trust Teaching Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

3 years to 10 years (Child)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • 3 to 10 years
  • Both genders will be included
  • Deficiency of shoulder abduction and external rotation
  • Who can follows command

Exclusion Criteria:

  • uncontrolled seizures
  • Orthopedic and/or neurological surgery.
  • A visual impairment interfering with treatment/testing.
  • Unable to actively engage in assessment process

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Conventional physical therapy treatment
Patients in this group will receive conventional physical therapy i.e. stretching, strengthening exercises, Aeroplan positioning
Other: Conventional physical therapy treatment

The control group (group A) will receive the exercise program which focused on improving the arm function as well as shoulder abduction and external rotation for 10 week.

stretching Aeroplan positioning
Experimental: Constraint induced movement therapy
patients of this group will receive the same treatment along with constraint induced movement therapy
Other: Constraint induced movement therapy
The study group (group B) who will receive Modified constraint induced movement therapy for 3 hrs. a day 12 hrs. a week in addition to the same exercise program given to the control group for 10 weeks.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Mallet grading system
Time Frame: 4 weeks
The Mallet grading system is a commonly used functional scoring system to assess shoulder abduction/external rotation deficits in children with obstetric brachial plexus palsy. One feature of the Mallet score is that each grade is translated in to certain degree of deficiencies in both shoulder abduction and external rotation. A scale of 1 to 5 is used to evaluate shoulder abduction, global external rotation, and hand to neck, hand to back, and hand to mouth positions.
4 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
goniometer
Time Frame: 4th week
changes from the baseline ROM of shoulder abduction and external rotation as well as elbow ranges was measured by goniometer was measured by can evaluate both active as well as passive range of motion.
4th week
Upper extremity function index
Time Frame: 4th week

It is a self-administered questionnaire which measures disability in people with upper extremity orthopaedic conditions. The questionnaire lists 20 activities and the patient gives a score to each based on the difficulty they have completing that activity. It is evaluated on a 5-point scale that refers to the perceived difficulty in performing the mentioned action:

  • Extreme difficulty or unable to perform activity (0 points);
  • Quite a bit of difficulty (1 point);
  • Moderate difficulty (2 points);
  • A little bit of difficulty (3 points);
  • No difficulty (4 points).

The overall Upper extremity function index (UEFI) result ranges between 0 and 80, where 0 indicates most severe limitation and 80 suggests least limitation. Changes from baseline function of affected extremity was given by this tool.
4th week

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Riphah International University

Investigators

  • Principal Investigator: Hafiza Mehjabeen, ppdpt, Riphah International University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 30, 2022

Primary Completion (Actual)

September 1, 2022

Study Completion (Actual)

September 1, 2022

Study Registration Dates

First Submitted

June 6, 2022

First Submitted That Met QC Criteria

June 6, 2022

First Posted (Actual)

June 9, 2022

Study Record Updates

Last Update Posted (Actual)

March 17, 2023

Last Update Submitted That Met QC Criteria

March 15, 2023

Last Verified

March 1, 2023

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • REC/RCR&AHS/22/0701

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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