Upper limb function and brain reorganization after constraint-induced movement therapy in children with hemiplegia

Objective: The aims of this study were to (1) investigate the effectiveness of CIMT for children with hemiplegia, (2) determine the feasibility of using fMRI for describing brain activity patterns before and after CIMT and (3) describe changes in brain reorganization after CIMT in children with hemiplegia using fMRI. Design: Before and after study with one group. Methods: Ten children aged 7-14 years (M = 11.0, SD = 2.5) with hemiplegia received CIMT over a 2-week period using a before and after design. Clinical measures included the Melbourne Assessment of Unilateral Upper Limb Function, upper limb kinematics and parent questionnaire. Children were measured with fMRI before and after CIMT. Results: Findings showed that CIMT may be effective at improving upper limb function in some, but not all children; those children with a moderate degree of impairment seemed to benefit the most. fMRI findings correlated moderately with clinical measures. Conclusion: Although unique challenges with fMRI data collection exist for this population, it provides potentially valuable information to better understand mechanisms of change after interventions such as CIMT.