Signature P-CIMT
This term was recently coined in a handbook of constraint therapy, along with alternative and group-based forms of pediatric constraint-induced movement therapy. Different approaches have been used, but specifically, we are going to share the approach that we used in our practice: the sensory-enhanced model.
The signature form of pediatric constraint-induced movement therapy has five elements:
- Constraint (splint or cast used on the stronger arm or hand)
- High Dose of Therapy (3-6 hours daily over 3-4 weeks)
- Shaping and Repetitive Practice
- Natural Environments
- Transition Planning
I am not going to spend time on the ACQUIREc acronym. Briefly, this protocol allows the children to receive six hours of therapy per day over four weeks, and a cast is applied to their stronger arm for that time. Later, we will outline the specifics that were slightly different for each child. For now, we will simply provide you the basic elements that comprise the acronym ACQUIREc:
- Acquisition of new motor skills
- Continuous practice with shaping to produce
- Quality movement of the
- Upper Extremity through
- Intensive therapy and
- Reinforcement in
- Everyday patterns and places
- C Casting
Research: P-CIMT
Traditionally, research of P-CIMT has involved looking at multi-dosage, multi-site, and different types of constraints. That is specifically what our clinic has focused on, in the past and also presently. We will discuss more about that toward the end of this presentation. Other areas of research in constraint have involved a group or a camp model versus the individual, and also repeat treatments (about which we have recently published an article in the AOTA journal).
