Summary of the CP-NET Clinical Constraint Therapy Study

Note: This summary was prepared for participants in a 2012 CP-NET Clinical Constraint Therapy study.

Thank you for participating in CP-NET Clinical Constraint Therapy study in the summer of 2012. If you recall, we held a Constraint Camp and took MRI images at the Robarts Imaging Centre. Our goal was to find out what changes in the brain could predict improvements from constraint therapy. We looked at MRI pictures of the brain and Occupational Therapy tests results from before the camp and one month after. For the children in the Constraint Camp there was also a 6-month follow-up. Here is a short summary of our results. The Occupational Therapy tests showed that on average hand function was better after the Constraint Camp. In children who did not participate in the camp, on average, there was no change in hand function. The camp improved most participants' ability to do daily tasks like grabbing and moving objects, and they were still able to do these tasks 6 months later. There were also interesting results related to the brain scans.

In this figure there are two pictures of the brain with motor activity coloured over in black. In the left picture, taken before the camp, there is a small amount of activity on the CP affected side of the brain (inside the circle), compared to the other side of the brain. In the picture on the right, taken after the camp, there is more activity on the CP affected side of the brain. After the Constraint Camp there is a better balance in activity between both sides of the brain. Interestingly, more improvements were made by children who had a greater imbalance in brain activity before starting the camp. A balance between the sides of the brain is a more typical activity pattern and helps us understand how constraint therapy may be working at a brain level. 

Thank you again for your continued support and participation in our research. More information about this study can be found at www.cp-net.org. 

Authors:

Darcy Fehlings
Ravi Menon
Craig Campbell
Jan Willem Gorter
Kathryn Manning
Ronit Mesterman
Lauren Switzer