Constraint Induced Movement Therapy in Obstetrical Brachial Plexus Palsy: Controlled, Randomized and Blind Trial

Research Objectives: To analyze the effects of Constraint Induced Movement Therapy (CIMT) in children with Obstetric Brachial Palsy (OBP), through the frequency, quality and spontaneity of use of the affected upper limb (AUL) and the acquisition of new motor programs after the treatment.

Design: Controlled, randomized and blinded clinical trial.

Setting: referral center in São Paulo - Brazil

Participants: The sample was 20 children aged 2 to 8 years

Interventions: Control Group (2 times/week, 40 minutes/day for three weeks) and Intervention Group (5 times/week, 3 hours /day for three weeks).

Main Outcome Measures: The assessment scales used were Pediatric Motor Activity Log– Revised (PMAL-R), Pediatric Arm Function Test (PAFT) and Inventory of New Motor Activities and Programs (INMAP). Non-parametric ANOVA analysis was used to compare results between groups.

Results: In post-treatment, both in amount of use (AOU) and in perception of quality (QOU) of the PMAL-R, the IG had better results, with the AOU 0.75 (very rare use) in the CG and 4.29 (75% of the time) in the GI; and QOU of 0.73 (very poor) for the CG and 4.47 (almost normal/normal) for the IG. In spontaneous tasks evaluated by PAFT the CG presented 11, while the IG 15. Regarding the quality of movement of the unimanual PAFT activities CG maintained 34 points, while the IG 65 points. Regarding the quality of movement in PAFT bimanual activities, the CG maintained 27 points, while the IG increased to 28.5 points. INMAP's motor programs had an increase only in the IG, going from 5 to 8, while the CG maintained the initial 4.

Conclusions: The CIMT showed an increase in the use of AUL in frequency, quality, spontaneity and acquired more motor programs after intervention, unlike the CG, which maintained the same results in relation to the pre-treatment moment.

Author(s) Disclosures: There is no conflict of interest