Effects of Modified Constrained Induced Movement Therapy to Improve the Upper Limb Functional Activities and Gross Manual Dexterity on Hemiparetic Cerebral Palsy Children Seema, Nagarani Shanmugam and Kannabiran Bhojan* RVS College of Physiotherapy, Coimbatore, Tamilnadu, India *Corresponding author: Kannabiran Bhojan, RVS College of Physiotherapy, Coimbatore, Tamilnadu, India, Tel: 91 9487968169; E-mail: physiokanna@gmail.com Rec date: May 25, 2015; Acc date: June 26, 2015; Pub date: July 02, 2015 Copyright: © 2015 Seema et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Background: cerebral palsy is a neuro developmental disorder. It has various types. Hemiparetic cerebral palsy is a type in which the children have limitations in capacity to use the impaired upper limb on daily life activities. This study aims to find out the effects of modified Constraint induced Movement therapy ( modified CIMT) to improve the upper limb functional activities and gross manual dexterity among the children with hemiparetic cerebral palsy. Methods: 10 children with hemiparetic cerebral palsy were undergone to modified CIMT. Interventions lasted for 4weeks, 4hrs/day, Peadiatric Motor Activity Log(PMAL) to assess the children's upper limb functional activities and box and block to assess gross manual dexterity were used before and after intervention. Results: The results showed significant improvements on functional measures of PMAL and gross manual dexterity of box and block. Conclusion: modified CIMT is an effective therapy to improve the upper limb functional activities and gross manual dexterity on the children with hemiparetic cerebral palsy. Keywords: Cerebral palsy; Modified constraint induced movement therapy; Paediatric motor activity log; Box and block; Gross manual dexterity Introduction Cerebral palsy (CP) is a neuro developmental disorder caused by non-progressive lesion in the immature brain. It may occur before, during or after birth. The early central nervous system damage results in physical disabilities and sensory impairments. The prevalence of cp is approximately 2- 2.5 per 1000 births, with hemiplegia accounting for approximately 25% of all new cases worldwide. CP is mainly classified to the spastic, ataxic, dystonic, and choreoathetosis. Hemiplegia is a type of spastic cerebral palsy [1-3]. Impaired hand function is a major debilitating factor for the performance of activities of daily living in hemiplegic cerebral palsy. The impairment of the hand is often the result of damage to the motor cortex and cortico spinal pathways responsible for the fine motor control of the fingers and hand [4]. Recent evidence suggests that children with CP may improve motor performance if provided with sufficient opportunities to practice. One treatment approach that is becoming increasingly popular is constraint-induced movement therapy (CIMT). Constraint Induced Movement therapy is a new technique used in physical rehabilitation to treat individuals with decreased upper extremity functions. It involves constraining the unaffected limb, along with intense therapy, in order to force the use of the affected side with the intent to improve motor function. It is a task driven treatment that combines principles of behavioral psychology and motor learning [5-9]. CIMT is a therapy for children with hemiplegia which involves encouraging use of the affected arm while restricting use of the unaffected arm. The types of restraints have included slings, mitts, splints, and casts. The restraint may be applied from a few hours up to twenty-four hours of a child's day. During the period of constraint the child may receive therapy to facilitate practice using the affected arm from as little as one hour to as much as six hours daily per week. The practice may be formal and structured involving behavioral shaping strategies or be less formal. Modified CIMT is vary in the frequency, duration, and type of constraint in treatment regimen [6-10]. Methods Study Design An experimental study was conducted to find out the effects of modified CIMT on children with hemiparetic Cerebral Palsy. Sample 10 subjects were selected after giving due consideration to inclusion and exclusion criteria. Sampling method Random sampling technique was used to select the samples. Inclusion Criteria • Diagnosis of hemiplegic cerebral palsy Bhojan K, et al., Int J Neurorehabilitation 2015, 2:3 DOI: 10.4172/2376-0281.1000169 Research Article Open Access Int J Neurorehabilitation ISSN:2376-0281 IJN an open access journal Volume 2 • Issue 3 • 169 I n t e r n a t i o n a l J o u r n a l o f N e u r o r e h a b i l i t a t i o n ISSN: 2376-0281 International Journal of Neurorehabilitation