Development of a Practical Guide for Pediatric Constraint-Induced Movement Therapy: Enhancing Understanding and Informed Decision-Making

Abstract

Importance

Constraint-induced movement therapy (CIMT) is an intervention for hemiplegic cerebral palsy (CP) that has a strong evidence base. CIMT has been shown to be effective in improving functional use of the more impaired upper extremity, yet has not become standard practice. Toolkits have been effectively used in various settings to increase intervention implementation; however, no guide currently exists to support clinical decision-making related to CIMT.

Objective

To provide an overview of the development of a practical guide for pediatric CIMT (pCIMT) that will aid therapists, other health care professionals, and families with children who may be eligible for pCIMT.

Design

Model development research.

Setting

Virtual communication secured in accordance with the Health Insurance Portability and Accountability Act of 1996 (Pub. L. 104-191).

Participants

Content experts (N = 12) with expertise related to pCIMT, hemiplegic CP, and occupational therapy who were recruited via purposive sampling to develop the practical guide.

Outcomes and Measures

Development of the practical guide followed a toolkit developmental model. Field notes were used to record all verbal and written feedback provided by content experts.

Results

The participants provided recommendations to include in the guide during the developmental phase. In two rounds of the expert review phase, they recommended revisions related to readability, content, and visuals. The final practical guide included six sections.

Conclusions and Relevance

A practical guide was developed to support occupational therapists, health care professionals, and caregivers in making an informed decision about whether pCIMT is the right intervention for a particular child.

Plain-Language Summary

Hemiplegic cerebral palsy is the most common motor disability that affects children, and it often causes difficulty moving one side of the body. Pediatric constraint-induced movement therapy (pCIMT) is an evidence-based intervention to help children use their more affected side. However, pCIMT is not widely available. With guidance from key informants, we designed a practical guide to support health care professionals and families in determining whether pCIMT could be an appropriate intervention. A three-phase toolkit development model was followed to design the practical guide. In this article, we report on Stages 1 and 2 (the development and expert review phases). Twelve experts and caregivers informed the development of the six sections of the practical guide. Future research should proceed to Stage 3 (the evaluation phase) to evaluate the effectiveness of the practical guide and identify implementation strategies for the guide to support pCIMT usage.

The authors designed a practical guide to support health care professionals and families in determining whether pediatric constraint-induced movement therapy (pCIMT) could be an appropriate intervention for a child with hemiplegic cerebral palsy.

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