What is necessity forced therapy in the treatment of MPD?

CIMT and cerebral palsy

Does your child suffer from cerebral palsy (MPD)? Constraint-Induced Movement Therapy(CIMT) may prove to be one of the most promising approaches in its rehabilitation. MPD is a neurological condition that affects motor development and posture, and hemiplegia - one of its forms - manifests as muscle weakness on only one side of the body. In children with this condition, a learned disuse of the weaker upper limb can be observed. Although this hand can perform basic tasks, the toddler prefers to use the fully functional one, resulting in increasing restrictions on the movements of the weakened limb. CIMT is a therapy for children with MPD that focuses on breaking these habits through intensive exercises and tasks designed to increase the strength, range of motion and functionality of the affected hand. In necessity-induced therapy, the side more affected by the paresis is actively engaged, which can greatly aid motor function.

Therapy forced by necessity - the most important information

What is forced necessity therapy? This is a rehabilitation method used for patients with brain damage (e.g. MPD, stroke, ischemic brain disease, post-traumatic brain injury) that has caused unilateral hemiparesis. By "forcing" we mean using various techniques to immobilize the healthy limb. The most common are sleeves or bands, which make it difficult to use it freely. As a result, the patient is forced to activate and use the weakened limb, which stimulates the brain to adapt and improve the functionality of the weakened side of the body. The effectiveness of CIMT has been confirmed by numerous studies, including the EXCITE (Extremity Constraint-Induced Therapy Evaluation) study, which showed that Patients who underwent forced-use therapy experienced significant improvements in the function of the weakened arm, and the effects developed persisted for up to a year after therapy ended.

Necessity forced therapy consists of 5 parts:

• Immobilization of the healthy limb through a cast, gloves, orthosis, bandage or sling,
• training conducted by a specialist in pediatric rehabilitation and orthopedics, who helps to effectively use the weakened limb through a variety of exercises and tasks tailored to the child's capabilities; systematically increasing the level of difficulty of the tasks, which stimulates the child to develop new skills and make better use of the weakened arm; monitoring progress and adjusting the therapeutic program, which allows to optimally adapt the exercises to the patient's current condition and needs, as well as supporting the family and educating them on the daily support of the child at home,
• use of shaping techniques,
• Therapy in a natural environment such as at home or school,
• a program for independent work at home to sustain the effects of CIMT.

The key benefits of CIMT therapy are:

• Increasing the functionality of the limb affected by the paresis - the use of CIMT focuses on intensive use of the weakened limb, which can lead to significant improvements in its strength, range of motion, endurance, dexterity and ability to perform daily activities;
• stimulation of the brain's neuroplasticity - regular exercise using forced-force therapy helps activate new neuronal pathways, which is key to the brain's adaptation to new conditions after damage;
• reducing learned disuse - hemiplegia in children often causes them to avoid using their weakened arm, which can lead to further dysfunction. CIMT helps break this habit by encouraging more frequent and effective use of the affected limb;
• Increased independence and self-confidence - improving hand function can significantly increase a child's independence in daily activities, resulting in a better quality of life and increased self-esteem.

The use of compulsive therapy by necessity requires careful evaluation by a specialist and customization of the rehabilitation program to meet the individual needs of the patient. Regular sessions with the therapist and the involvement and cooperation of the parents are key to achieving optimal results.

Summary

You already know what CIMT is. It's an innovative rehabilitation method that helps MPD patients improve the function of a weakened limb by limiting the movements of the healthy hand. In this way, the therapy stimulates neuroplasticity and counteracts the phenomenon of learned disuse. Want to learn more? Contact the Paley European Institute! Our specialists will answer all your questions!