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Sensory-Enhanced Pediatric Constraint Induced Movement Therapy

Sensory-Enhanced Pediatric Constraint Induced Movement Therapy
Mary Rebekah Trucks, OTR/L, Dory Ainsworth Wallace, MS, OTR/L
April 28, 2016
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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).


mary rebekah trucks

Mary Rebekah Trucks, OTR/L

Mary Rebekah Trucks, MS, OTR/L is a senior occupational therapist and research faculty with the Neuromotor Research Clinic at the Virginia Tech Carilion Research Institute.  She has 15 years of clinical and research experience in Pediatric Constraint Induced Movement Therapy.  She has assisted in developing the clinical applications of ACQUIREc and Pediatric CI Therapy and has trained numerous therapists in this approach.  She has presented at numerous State and National Occupational Therapy Association meetings. 


dory ainsworth wallace

Dory Ainsworth Wallace, MS, OTR/L

Dory Wallace, MS, OTR/L is a senior occupational therapist and research faculty with the Neuromotor Research Clinic at the Virginia Tech Carilion Research Institute.  She has 12 years of clinical experience in Pediatric Constraint Induced Movement Therapy, school based occupational therapy, and skilled nursing.  She assisted in research and developing various clinical applications of the ACQUIREc model of Pediatric Constraint Induced Therapy.  She has presented at State and National Occupational Therapy Association meetings.



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