Constraint-induced movement therapy for children with acquired brain injury: didactical approach
and functional change
Sammanfattning
An estimated 125-137 Danish children with acquired brain injury (ABI) require rehabilitation
annually, 30-40 of these at a highly specialized level. Constraint-induced movement therapy (CIMT)
has shown significant effects in increasing function in children with cerebral palsy. More knowledge
of how CIMT can be adapted for the rehabilitation of children with ABI is needed. The primary purpose
of the study was to generate new knowledge about the pedagogical initiatives and frameworks
involved in children’s participation in and activities during CIMT. Four children with ABI participated
in the 60 h intervention. Data generation consisted of qualitative research through participant
observations and healthcare professional evaluations. A didactical approach with individualization
and a solid structural framework enhanced the possibility of securing the children’s motivation for
and participation in the intervention. Adaptation, compensation and individualization were crucial
factors in the achievement of changes in functional skills. Spontaneous functional use and natural
bimanual involvement increased, indicating that CIMT intervention encourages the retrieval of natural
involvement of the impaired upper limb after ABI. Individualization, attention, firm structure and
goal-specific tasks are key didactical factors to maintain children’s motivation to participate during
CIMT to increase functional skills and spontaneous and natural bimanual involvement of the impaired
upper limb during activities.