The overall objective of this research is to test the efficacy of a new form of pediatric rehabilitation therapy -namely, Pediatric CI therapy - to promote new and improved motor behavior in young children with hemiparesis associated with cerebral palsy. This is based on a theoretically-grounded therapy shown to be effective with adult patients with chronic stroke and to produce cortical reorganization (cf. Taub et al., 1993; Liepert et al., 2000). Pediatric Cl therapy involves (1) total restraint of the unaffected upper extremity and (2) repetitive use of the affected extremity, using intensive shaping procedures for 6 hours/day for 21 consecutive days. The proposed research builds on findings from a preliminary study that demonstrated significant gains in young children's upper extremity skills following Pediatric Cl therapy. We propose to conduct a prospective, randomized controlled study with 52 children (ages 2-6) with hemiparetic cerebral palsy.
The specific aims are:(1) to test the efficacy of Pediatric Cl therapy compared to Conventional therapy to improve upper extremity movement and functional use;(2) to evaluate whether improvement (if detected) is sustained over the next 12 months; and(3) to assess whether Pediatric Cl therapy is associated with significant gains in other adaptive behavior domains (e.g., trunk control, mobility, communication, and self-help skills).This research is of paramount significance because there currently are no forms of pediatric rehabilitation proven efficacious (Barry, 2001), despite widespread use of physical and occupational therapy in treatment of young children with cerebral palsy (Ramey et al; 2000).

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD040692-04
Application #
7107153
Study Section
Special Emphasis Panel (ZRG1-BDCN-5 (01))
Program Officer
Nicholson, Carol E
Project Start
2002-09-04
Project End
2008-06-30
Budget Start
2006-07-01
Budget End
2008-06-30
Support Year
4
Fiscal Year
2006
Total Cost
$325,587
Indirect Cost
Name
University of Alabama Birmingham
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
063690705
City
Birmingham
State
AL
Country
United States
Zip Code
35294
Sokal, Brad; Uswatte, Gitendra; Vogtle, Laura et al. (2015) Everyday movement and use of the arms: Relationship in children with hemiparesis differs from adults. J Pediatr Rehabil Med 8:197-206
Uswatte, Gitendra; Taub, Edward; Griffin, Angi et al. (2012) Pediatric Arm Function Test: reliability and validity for assessing more-affected arm motor capacity in children with cerebral palsy. Am J Phys Med Rehabil 91:1060-9
Uswatte, Gitendra; Taub, Edward; Griffin, Angi et al. (2012) The pediatric motor activity log-revised: assessing real-world arm use in children with cerebral palsy. Rehabil Psychol 57:149-58
Taub, Edward; Griffin, Angi; Uswatte, Gitendra et al. (2011) Treatment of congenital hemiparesis with pediatric constraint-induced movement therapy. J Child Neurol 26:1163-73
Taub, Edward; Griffin, Angi; Nick, Jennifer et al. (2007) Pediatric CI therapy for stroke-induced hemiparesis in young children. Dev Neurorehabil 10:3-18