What is baby-CIMT?
Constraint induced movement therapy (CIMT) is a well-researched treatment modality for partial paraplegia in children over 18 months of age. Baby-CIMT is a modification of CIMT designed for infants and infants younger than 18 months who are at risk for hemiplegic cerebral palsy (CP).
Baby-CIMT is characterized by the same features as CIMT:
- Constraint of the stronger arm and hand
- An intense structured training of the involved hands that includes several repetitions
- Challenging but achievable task-based activities
- Providing positive feedback and encouraging physical education
Its primary purpose is to increase the use of the affected hand by providing more opportunities for the child to repeat tasks with the affected hand so that growth and addiction continue. To this end, a restriction is applied to the unaffected alcohol during treatment period. Children are encouraged and stimulated to use their upper limbs through play and exploration in their everyday environment and toys and this is something parents can do with a therapist see below.
Early intervention
Early intervention is needed because learning-induced brain plasticity in early childhood appears to have a distinct impact on brain development[1]. Baby-CIMT takes advantage of the plastic nature of the developing brain and our knowledge of activity-dependent cortical reorganization and aims to influence the child’s hand function development. Two key components of physical learning are repetition and positive feedback. Babies are very sensitive to encouragement and learn skills through encouragement and feedback from their parents.
There are no official guidelines to date regarding the dosage and age of initiation of intensive infant-CIMT. In more recent studies[2] it is recommended that infant-CIMT begin when handedness dysregulation is first detected (usually around 3-5 years of age). Training should begin when the baby begins to show environmental interests trying to explore and understand. “At a young age,” Eliasson says, “it can be difficult to tell whether hand function dysregulation will lead to unilateral CP or loss. But proper training will not harm any child development”[2].
The evidence
There is currently very little evidence of the effects of infant-CIMT. This is because it is a relatively new treatment for these young children and is still under investigation. Among the major barriers to early intervention in infant research is lack of clarity lack of research and tools to assess the development of hand function at such a young age. A 2015 study comparing hand function between two-year-olds who received baby-CIMT and children who didn’t found that children who received baby-CIMT were six times more likely to do so they are more likely to have higher levels of activity at two years of age than untreated children[3]. The most recent research study in 2018 gave a training total of 36 hours in total divided into two periods of six weeks with the babies having a limit on their. alcohol that did not stop for 30 minutes per day and was given treatment during this period[2]. Compared to infant injections[4], children receiving infant-CIMT showed significant improvements in unimanual ability on the Hand Assessment for Infants (HAI)[5][6 ].
Conclusion & Clinical implications
Consistent with the results of the CIMT study in older children[7], infant-CIMT appears to have a positive effect on early hand function and may even be beneficial for later hand function this[ The few studies we have suggest that there are evidence of effectiveness of baby-CIMT but more research is needed[8]. Further clinical trials should investigate the effectiveness of infant-CIMT compared with other early intervention therapies, the optimal dose intensity being the age of initiation and that of infant- . CIMT gets longer as well. Alright it is important to note that no adverse effects were reported in any assessment by therapists or parents.
References
- ↑ Basu, A. P., Pearse, J., Kelly, S., Wisher, V., & Kisler, J. (2015). Early intervention to improve hand function in hemiplegic cerebral palsy. Frontiers in neurology, 5, 281.
- ↑ Jump up to:2.0 2.1 2.2 2.3 Eliasson, A. C., Nordstrand, L., Ek, L., Lennartsson, F., Sjöstrand, L., Tedroff, K., & Krumlinde-Sundholm, L. (2018). The effectiveness of Baby-CIMT in infants younger than 12 months with clinical signs of unilateral-cerebral palsy; an explorative study with randomized design. Research in developmental disabilities, 72, 191-201.
- ↑ Nordstrand, L., Holmefur, M., Kits, A., & Eliasson, A. C. (2015). Improvements in bimanual hand function after baby-CIMT in two-year old children with unilateral cerebral palsy: A retrospective study. Research in developmental disabilities, 41, 86-93.
- ↑ Eliasson AC, Sjöstrand L, Ek L, Krumlinde-Sundholm L, Tedroff K. Efficacy of baby-CIMT: study protocol for a randomised controlled trial on infants below age 12 months, with clinical signs of unilateral CP. BMC pediatrics. 2014 Dec;14(1):1-1.
- ↑ Krumlinde‐Sundholm, L., Ek, L., & Eliasson, A. C. (2015). What assessments evaluate use of hands in infants? A literature review. Developmental Medicine & Child Neurology, 57(s2), 37-41.
- ↑ Krumlinde‐Sundholm, L., Ek, L., Sicola, E., Sjöstrand, L., Guzzetta, A., Sgandurra, G., & Eliasson, A. C. (2017). Development of the Hand Assessment for Infants: evidence of internal scale validity. Developmental Medicine & Child Neurology, 59(12), 1276-1283.
- ↑ Chiu, H. C., & Ada, L. (2016). Constraint-induced movement therapy improves upper limb activity and participation in hemiplegic cerebral palsy: a systematic review. Journal of physiotherapy, 62(3), 130-137.
- ↑ Eliasson, A. C., Krumlinde‐Sundholm, L., Gordon, A. M., Feys, H., Klingels, K., Aarts, P., & Hoare, B. (2014). Guidelines for future research in constraint‐induced movement therapy for children with unilateral cerebral palsy: an expert consensus. Developmental Medicine & Child Neurology, 56(2), 125-137.
