Clients' perspective on modified constraint induced movement therapy for students with hemiplegic cerebral palsy : a pilot study in Hong Kong special schools

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Clients' perspective on modified constraint induced movement therapy for students with hemiplegic cerebral palsy : a pilot study in Hong Kong special schools

 

Author: Yuen, Man-lung Ricky
Title: Clients' perspective on modified constraint induced movement therapy for students with hemiplegic cerebral palsy : a pilot study in Hong Kong special schools
Degree: M.Sc.
Year: 2009
Subject: Hong Kong Polytechnic University -- Dissertations
Cerebral palsied children -- Rehabilitation -- China -- Hong Kong
Movement therapy for children -- China -- Hong Kong
Hemiplegics -- Rehabilitation
Department: Dept. of Rehabilitation Sciences
Pages: xi, 139 leaves : ill. ; 30 cm.
InnoPac Record: http://library.polyu.edu.hk/record=b2356224
URI: http://theses.lib.polyu.edu.hk/handle/200/5839
Abstract: Modified constraint-induced movement therapy (mCIMT) is a relatively new but effective treatment approach for children with hemiplegic cerebral palsy (CP) to overcome "developmental disregard" of their affected upper limb and to improve its function. Previous studies, mainly conducted in laboratory or clinical setting, involved high intensity of structured training and extensive time of participation in the settings. This treatment protocol is resource-intensive. Children's regular study would also be disturbed when they participated in such protocol during schooling time. The study aims at developing and conducting a school-based mCIMT protocol and a set of activities for structured training, which would allow children to continue normal study in school. Ten children with hemiplegic CP from two schools for students with physical handicap were invited in this study. The treatment last for fifteen days within three weeks. Subjects were required to restrain their unaffected upper extremity with a sling for six hours daily during the school hours. A one-hour structured training was provided in a group format after lunch. In the rest of five-hour restraint time, children could attend regular lessons and participate in daily routine tasks as usual. After, conducting school-based mCIMT, the perspectives of different parties on mCIMT, including students, parents and school staff, were explored through a qualitative approach. There was an inspiring result that improvement of affected upper extremity was noticed. Students perceived improvement of their affected upper extremity, especially in function use of hand and strength. Parents also reported enhancement of bilateral hand coordination and increased autonomy of using affected upper extremity of their children when performing daily tasks at home. However, teachers reported the positive changes were temporary, lasting for about one month only. Besides, school staff believed that mCIMT was feasible to be integrated into school routine without huge amount of extra resources. Recommendations, which helped further improve the present mCIMT protocol, were suggested in various interviews with children, parents and staff. The effectiveness and long-term benefit of the revised school-based mCIMT protocol can be explored in future research.

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