Effects of CIMT With and Without MIT on Upper Limb of Children With Hemiparetic CP

Effects of Constraint Induced Movement Therapy With and Without Motor Imagery Technique on Upper Limb of Children With Hemiparetic Cerebral Palsy

Cerebral Palsy (CP) is a major cause of motor disability in children. Among these CP children, approximately one third have hemiparetic cerebral palsy. Hemiparetic cerebral palsy is more impairment of one side of the body as a result of non-progressive disturbances in premature brain.To determine the effects of implementing a practice period of modified constraint induced movement therapy in a virtual environment on hand function in chidren with hemiparetic cerebral palsy.

Study Overview

• Status: Completed
• Conditions: Cerebral Palsy
• Intervention / Treatment: Device: Modified Constraint Induced Movement Therapy; Other: Motor Imagery Technique

Detailed Description

To determine the effects of implementing a practice period of modified constraint induced movement therapy in a virtual environment on hand function in chidren with hemiparetic cerebral palsy.The term Modified constraint-induced movement therapy is a form of rehabilitation therapy that limits the less paretic side, and through repeated and concentrated training improve the upper limb function of the paretic side. Motor imagery is a cognitive process in which a subject imagines that he or she performs a movement without actually performing the movement and without even tensing the muscles. Modified Constraint induced movement therapy can be utilized in both the lower and upper extremities with the motor imagery technique for psychological or occupational therapy and in affecting which one is better for speedy recovery.

• Study Type: Interventional
• Enrollment (Actual): 22
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab
    • Lahore, Punjab, Pakistan, 54000
      • Riphah International University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age 6 to 14 years were included.
• Diagnosed of hemiparetic cerebral palsy and typically developing controls.
• Both gender is included i-e, male and female.
• Children included having motor impairments of upper limb.
• All children had normal or corrected vision and the ability to discriminate between right and left.

Exclusion Criteria:

• History of neurosensory and neuropsychiatric impairments.
• Presence of contractures in the affected upper limb.
• Surgery in the previous six months.
• Uncontrolled epilepsy

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Modified Constraint Induced Movement Therapy; Group that will be provided with Modified Constraint Induced Movement Therapy. A protocol of 10 minutes of MCIMT therapy will be given including constraints.	Device: Modified Constraint Induced Movement Therapy; Modified Constraint Induced Movement Therapy
Experimental: Motor Imagery Technique; Group that will be provided with Motor Imagery Technique by grasping an object and placing it into a container, or in imagining to perform the same action.	Other: Motor Imagery Technique; Motor Imagery Technique

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
QUEST (Quality of Upper Extremity Skills Test)	Item The Quality of Upper Extremity Skills Test is an outcome measure designed to evaluate movement patterns and hand function in children with cerebral palsy. The QUEST is both reliable and valid. The purpose of the QUEST is to evaluate quality of upper extremity function in four domains: dissociated movement,grasp,protective extension, and weight bearing. Scores of 1 or 2, determined by quality of assessed position or movement; 1 if movement quality is not achieved, 2 if movement quality is achieved. Item scores are summed; formulas are used to calculate percentages for each domain. Domain percentages are summed and divided by number of domains to obtain total score. Minimum score = 0, Maximum score = 100.	8 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Box and Block Test (BBT)	The Box and Block Test (BBT) measures unilateral gross manual dexterity. It is a quick, simple and inexpensive test. It can be used with a wide range of populations. Clients are scored based on the number of blocks transferred from one compartment to the other compartment in 60 seconds. Score each hand separately. Higher scores are indicative of better manual dexterity. During the performance of the BBT, the evaluator should be aware of whether the client's fingertips are crossing the partition. Blocks should be counted only when this condition is respected. Furthermore, if two blocks are transferred at once, only one block will be counted. Blocks that fall outside the box, after trespassing the partition, even if they don't make it to the other compartment, should be counted.	8 weeks

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Khansa Khalid, MS, Riphah International University

Publications and helpful links

General Publications

• Steenbergen B, Gordon AM. Activity limitation in hemiplegic cerebral palsy: evidence for disorders in motor planning. Dev Med Child Neurol. 2006 Sep;48(9):780-3. doi: 10.1017/S0012162206001666.
• Humphreys P, Whiting S, Pham B. Hemiparetic cerebral palsy: clinical pattern and imaging in prediction of outcome. Can J Neurol Sci. 2000 Aug;27(3):210-9.

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2023
• Primary Completion (Actual): February 15, 2024
• Study Completion (Actual): February 15, 2024

Study Registration Dates

• First Submitted: December 26, 2023
• First Submitted That Met QC Criteria: January 28, 2024
• First Posted (Actual): February 5, 2024

Study Record Updates

• Last Update Posted (Actual): June 13, 2024
• Last Update Submitted That Met QC Criteria: June 11, 2024
• Last Verified: June 1, 2024

More Information

Terms related to this study

• Keywords: MCIMT, Motor Imagery Technique, Hemiparetic CP, RCT
• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Brain Damage, Chronic; Cerebral Palsy
• Other Study ID Numbers: REC/RCR&AHS/23/0743

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