ABSTRACT

Objective : The purpose of this study was to investigate the effect of Modified Constraint-Induced Therapy (MCIT) on fine-motor function, or the sensory and functional use of an affected upper extremity in daily activities.Methods : Four children with hemiparetic upper extremity caused by brain injuries were trained by MCIT for ten weeks. During the treatment period, the unaffected upper extremities of the subjects were restrained by a specially designed hand splint or a mitten for five hours a day, five days per week. For two hours out of the five-hour restraint period, the affected upper extremity was intensively trained by performing various functional tasks, which were individually structured to emphasize use of the affected arm. A single-subject design with A-B-A reversal was employed in this study. The affected limb motor ability was evaluated by Melbourne Assessment. Sensory abilities of the hemiparetic upper limb were assessed, using monofilaments and two-point discrimination tests.Results : As a consequence of this study, the affected limb motor test scores of all four subjects in the baseline period were respectively improved during the treatment period. Furthermore, the treatment effect was maintained during a one-month follow-up period. The sensibility of two-point discrimination and light touch and pressure was also improved after MCIT. In addition, the parents of all four children reported that their children began to use the paretic upper extremity more frequently in daily functional activities at home.Conclusion : The results of this study support the assumption that MCIT is an effective therapeutic method to improve the sensory and motor abilities of hemiparetic children, and that it also increases the frequency of functional use of the hemiparetic hands of brain-injured children. Based on the results of this study, it can also be assumed that the MCIT method is especially beneficial to these children by reducing the negative emotional effects of forceful restraint of the unaffected upper extremity. To optimize the functional recovery of the paretic upper extremity by CIT, the restriction period per day should be decided individually, according to the characteristics of the individual.