Medical Professional Publications

Sensory-focused Constraint Induced Movement Therapy for Infants and Toddlers with Cerebral Palsy

Columbus, OH - June 2016

Children with hemiplegic or asymmetric cerebral palsy neglect their most-affected extremities, making it difficult to improve motor function or learn new movements. That neglect of extremities, known as developmental disregard, causes even children undergoing intensive standard therapy to sometimes lag behind typically developing kids.

Constraint-induced motor therapy (CIMT) has worked in some adults and older children to help overcome developmental disregard. In CIMT, the better-functioning upper extremity is constrained for a period of time, leading the patient to use the poorer-functioning extremity (with the guidance of professional therapists).

Previous research on CIMT for patients with cerebral palsy has largely focused on older children and intensive training with therapists in the hospital or in the home. New neuroscientific evidence suggests that CIMT combined with bi-manual therapy and a strong focus on sensory exposures may maximize the benefits of treatment. CIMT could have an even greater impact on infants and toddlers especially if parents can administer it at home with a unique soft mitt harness leveraging both therapist training and positive psychology principles. That’s what a randomized clinical trial at Nationwide Children’s Hospital aims to find out.

Called APPLES – A Positive Parent-focused training for upper Limb Experience with Sensory-motor feedback – the study is led by Nathalie L. Maitre, MD, PhD, director of the NICU Follow-up Program and NICU Music Therapy Program at Nationwide Children’s, and a principal investigator in the Center for Perinatal Research. Dr. Maitre’s lab is enrolling children 9 to 27 months old diagnosed with hemiplegic or asymmetric cerebral palsy, and children in the same age range with no motor difficulties to act as a control group.

Read about APPLES in detail, and watch a video of young children undergoing CIMT, on the study’s webpage.

Chorna O, Heathcock J, Key A, Noritz G, Carey H, Hamm E, Nelin MA, Murray M, Needham A, Slaughter JC, Maitre NL. Early childhood constraint therapy for sensory/motor impairment in cerebral palsy: a randomised clinical trial protocol. BMJ Open. 2015 Dec 7;5(12):e010212.   

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