Implementation of Therapy Together With Early Childhood Intervention

NCT06853717 | Completed

• 1 other identifier: IRB-FY2022-258
• Study Type: interventional
• Target: 5
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this project is to conduct a pilot hybrid type two implementation and efficacy study on Therapy Together with Early Childhood Intervention using an explanatory mixed methods approach to evaluate the efficacy and implementation of Therapy Together. Therapy Together is a parent led intensive pediatric constraint induced movement therapy (P-CIMT) program for young children (3 months-2 years 11 months) with unilateral cerebral palsy (UCP). The research team developed the Therapy Together program due to the lack of clinical uptake in use of CIMT with children with UCP, even though there is consistent and robust evidence that demonstrates a positive treatment effect with the intervention. Therapy Together is based on the evidence and active ingredients of P-CIMT with a primary focus on utility and translation of research to clinical practice.

Conditions

Unilateral Cerebral Palsy

Keywords

Constraint Induced Movement Therapy; Pediatric Constraint Induced Movement Therapy; Early Childhood Intervention; Therapy Together

Outcome Measures

Primary Outcomes (4)

• Mini-Assisting Hand Assessment (Mini-AHA)

  A semi-structured assessment for unilateral CP measuring effectiveness in bimanual hand

  pre-intervention and immediate post-intervention

• Canadian Occupational Performance Measure (COPM)

  A semi-structured interview that allows caregivers to evaluate and prioritize their child's current participation in the areas of self-care, leisure, and play

  pre-intervention and immediate post-intervention

• Developmental Assessment of Young Children, Second Edition (DAYC-2)

  The DAYC-2 is a normative-based assessment to identify children from birth to 5 years of age to assess a child's ability in areas of cognition, communication, social-emotional development, physical development, and adaptive behavior

  pre-intervention and immediate post-intervention

• Measure of Hand and Arm Performance

  The measure of hand and arm performance is an observation-based assessment of upper extremity movements developed by the researchers.

  pre-intervention and immediate post-intervention

Study Arms (1)

Therapy Togther

EXPERIMENTAL

Therapy Together is a parent led intensive pediatric constraint induced movement therapy (P-CIMT) program for young children (3 months-2 years 11 months) with unilateral cerebral palsy (UCP). The research team developed the Therapy Together program due to the lack of clinical uptake in use of CIMT with children with UCP, even though there is consistent and robust evidence that demonstrates a positive treatment effect with the intervention. Therapy Together is based on the evidence and active ingredients of P-CIMT with a primary focus on clinical utility and translation of research to clinical practice

Behavioral: Therapy Together

Interventions

Therapy Together BEHAVIORAL

CIMT consists of retraining the preferred hand by covering the hand with a soft mitt to promote the use of the assisting hand. With consistent practice, a toddler or infant builds the fine and gross motor skills of their assisting hand and bilateral coordination skills.

Also known as: Constraint Induced Movement Therapy

Therapy Togther

Eligibility Criteria

• Age: 3 Months - 3 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

Sponsors & Collaborators

• Texas Scottish Rite Hospital for Children: lead
• Texas Woman's University: collaborator

Study Sites (1)

Texas Woman's Univeristy

Denton, Texas, 76201, United States

Location

Related Publications (20)

• Armstrong RW. Definition and classification of cerebral palsy. Dev Med Child Neurol. 2007 Mar;49(3):166. doi: 10.1111/j.1469-8749.2007.00166.x. No abstract available.

  PMID: 17355470 BACKGROUND

• Cioni G, D'Acunto G, Guzzetta A. Perinatal brain damage in children: neuroplasticity, early intervention, and molecular mechanisms of recovery. Prog Brain Res. 2011;189:139-54. doi: 10.1016/B978-0-444-53884-0.00022-1.

  PMID: 21489387 BACKGROUND

• Creswell, J. W., & Creswell, J. D. (2018). Research design: Qualitative, quantitative, and mixed methods approaches. (5th ed). Sage Publications, 267-276.

  BACKGROUND

• Eliasson AC, Krumlinde-Sundholm L, Rosblad B, Beckung E, Arner M, Ohrvall AM, Rosenbaum P. The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability. Dev Med Child Neurol. 2006 Jul;48(7):549-54. doi: 10.1017/S0012162206001162.

  PMID: 16780622 BACKGROUND

• Eliasson AC, Nordstrand L, Ek L, Lennartsson F, Sjostrand L, Tedroff K, Krumlinde-Sundholm L. The effectiveness of Baby-CIMT in infants younger than 12 months with clinical signs of unilateral-cerebral palsy; an explorative study with randomized design. Res Dev Disabil. 2018 Jan;72:191-201. doi: 10.1016/j.ridd.2017.11.006. Epub 2017 Nov 23.

  PMID: 29175749 BACKGROUND

• Eliasson AC, Ullenhag A, Wahlstrom U, Krumlinde-Sundholm L. Mini-MACS: development of the Manual Ability Classification System for children younger than 4 years of age with signs of cerebral palsy. Dev Med Child Neurol. 2017 Jan;59(1):72-78. doi: 10.1111/dmcn.13162. Epub 2016 Jun 8.

  PMID: 27273427 BACKGROUND

• Lidbeck C, Habel H, Martinsson C, Pettersson K, Lowing K. Motor Development in Children with Cerebral Palsy in Sweden-A Population-Based Longitudinal Register Study. Children (Basel). 2023 Nov 28;10(12):1864. doi: 10.3390/children10121864.

  PMID: 38136066 BACKGROUND

• Novak I, Morgan C, Adde L, Blackman J, Boyd RN, Brunstrom-Hernandez J, Cioni G, Damiano D, Darrah J, Eliasson AC, de Vries LS, Einspieler C, Fahey M, Fehlings D, Ferriero DM, Fetters L, Fiori S, Forssberg H, Gordon AM, Greaves S, Guzzetta A, Hadders-Algra M, Harbourne R, Kakooza-Mwesige A, Karlsson P, Krumlinde-Sundholm L, Latal B, Loughran-Fowlds A, Maitre N, McIntyre S, Noritz G, Pennington L, Romeo DM, Shepherd R, Spittle AJ, Thornton M, Valentine J, Walker K, White R, Badawi N. Early, Accurate Diagnosis and Early Intervention in Cerebral Palsy: Advances in Diagnosis and Treatment. JAMA Pediatr. 2017 Sep 1;171(9):897-907. doi: 10.1001/jamapediatrics.2017.1689.

  PMID: 28715518 BACKGROUND

• Novak I, Morgan C, Fahey M, Finch-Edmondson M, Galea C, Hines A, Langdon K, Namara MM, Paton MC, Popat H, Shore B, Khamis A, Stanton E, Finemore OP, Tricks A, Te Velde A, Dark L, Morton N, Badawi N. State of the Evidence Traffic Lights 2019: Systematic Review of Interventions for Preventing and Treating Children with Cerebral Palsy. Curr Neurol Neurosci Rep. 2020 Feb 21;20(2):3. doi: 10.1007/s11910-020-1022-z.

  PMID: 32086598 BACKGROUND

• Palisano, R., Rosenbaum, P., Bartlett, D., & Livingston, M. (2007). Gross Motor Classification System expanded and revised. CanChild Centre for Childhood Disability Research. Retrieved on July 1, 2023 from https://canchild.ca/system/tenon/assets/attachments/000/000/058/original/GMFCS-ER_English.pdf

  BACKGROUND

• Ramey SL, DeLuca SC, Stevenson RD, Conaway M, Darragh AR, Lo W; CHAMP. Constraint-Induced Movement Therapy for Cerebral Palsy: A Randomized Trial. Pediatrics. 2021 Nov;148(5):e2020033878. doi: 10.1542/peds.2020-033878. Epub 2021 Oct 14.

  PMID: 34649982 BACKGROUND

• Sadowska M, Sarecka-Hujar B, Kopyta I. Cerebral Palsy: Current Opinions on Definition, Epidemiology, Risk Factors, Classification and Treatment Options. Neuropsychiatr Dis Treat. 2020 Jun 12;16:1505-1518. doi: 10.2147/NDT.S235165. eCollection 2020.

  PMID: 32606703 BACKGROUND

• Sakzewski L, Ziviani J, Boyd RN. Efficacy of upper limb therapies for unilateral cerebral palsy: a meta-analysis. Pediatrics. 2014 Jan;133(1):e175-204. doi: 10.1542/peds.2013-0675. Epub 2013 Dec 23.

  PMID: 24366991 BACKGROUND

• Saleh MN, Korner-Bitensky N, Snider L, Malouin F, Mazer B, Kennedy E, Roy MA. Actual vs. best practices for young children with cerebral palsy: a survey of paediatric occupational therapists and physical therapists in Quebec, Canada. Dev Neurorehabil. 2008 Jan-Mar;11(1):60-80. doi: 10.1080/17518420701544230.

  PMID: 17943507 BACKGROUND

• Shierk, A., Roberts, H., Dubberly, K., Clegg, N. J., Fagan, M., Baldwin, D., Reyes, F., VanPelt, J., & Delgado, M. R. (2023). Therapy together: A caregiver led constraint induced movement therapy program for preschool aged children utilizing a virtual environment due to COVID 19. Journal of Occupational Therapy, Schools, and Early Intervention, 16(1), 39-50. https://doi.org/10.1080/19411243.2021.2003738

  BACKGROUND

• Squires A, Sadarangani T, Jones S. Strategies for overcoming language barriers in research. J Adv Nurs. 2020 Feb;76(2):706-714. doi: 10.1111/jan.14007. Epub 2019 Jun 17.

  PMID: 30950104 BACKGROUND

• Svensson K, Sundelin H, Eliasson AC. Outcomes of a Parent-Delivered Baby-mCIMT Model for Infants at High Risk of Unilateral Cerebral Palsy Using Remote Coaching in Telerehabilitation. Children (Basel). 2024 Jan 15;11(1):101. doi: 10.3390/children11010101.

  PMID: 38255414 BACKGROUND

• Texas Health and Human Services Commission. (n.d.). Early childhood intervention services (ECI). Retrieved on July 1, 2023 from https://www.hhs.texas.gov/services/disability/early-childhood-intervention-services-eci

  BACKGROUND

• U.S. Census Bureau. (2022). Limited English speaking households. American Community Survey, ACS 1-Year Estimates Subject Tables, Table S1602. https://data.census.gov/table/ACSST1Y2022.S1602?t=Language Spoken at Home&g=040XX00US48

  BACKGROUND

• World Health Organization. (2007). International classification of functioning, disability and health, children & youth version (ICF-CY). World Health Organization. https://www.who.int/standards/classifications/international-classification-of-functioning-disability-and-health

  BACKGROUND

MeSH Terms

Interventions

Constraint Induced Movement Therapy

Intervention Hierarchy (Ancestors)

Exercise Therapy; Physical Therapy Modalities; Therapeutics; Rehabilitation

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: pre- and post- assessment

Study Record Dates

• First Submitted: February 25, 2025
• First Posted: March 3, 2025
• Study Start: February 16, 2022
• Primary Completion: September 14, 2023
• Study Completion: September 14, 2023
• Last Updated: March 5, 2025

Record last verified: 2025-02

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)