Children's Hospitals & Clinics of Minnesota offers Pediatric Constraint Induced Movement Therapy (PCIMT). Constraint Induced Movement Therapy is a program to improve movement and strength in a child who has weakness on one side of the body.

A constraint (cast or splint) is applied to the stronger arm and hand to limit movement for four weeks. This encourages more movement of the weaker arm and hand. The child then participates in six hours of therapeutic training and re-education for 21 days over the course of the four weeks.

Children's offers a full program and a modified program. Both methods have led to reports of improved movement in children with hemiplegia. Many of the research studies have used different tools to measure the amount of change, making it difficult for us to accurately compare the methods.

The modified program requires less time commitment from families, and therefore, may be more accessible in some cases. The full program provides more therapeutic training and re-education, which have been found beneficial in studies published thus far. In those situations where identical length of treatment was used, the children who received the full program of PCIMT and were able to practice more demonstrated greater change than the children who received a modified program of PCIMT.

Full Program of PCIMT

What is the full program of PCIMT?

The full program of PCIMT consists of 6 hours of therapy each day for 21 days over the course of four weeks. In addition, your child will wear a constraint 24 hours a day for 4 weeks. Treatment goals will be set based on needs identified collaboratively between the family and the therapist. Treatment will be given in a child-friendly environment and consist of a mix of typical daily activities such as getting dressed and eating along with age appropriate gross motor play (crawling, climbing) and fine motor play (picking up toys, manipulating objects). Your child will participate in extensive practice and repetition of movements and problem solving and will receive positive praise and reinforcement of desired movements and skills.

How is my child constrained?

A full-length fiberglass cast will be placed on your child's dominant arm and hand. The cast will have an opening on one side that will allow the staff to remove the cast once per week to check your child's skin and provide an opportunity to stretch and move the arm. Although it is possible for the cast to be easily removed by a parent or the treating therapist, we ask that it be removed for brief periods only by the casting therapist.

Modified program of PCIMT

What is modified CIMT?

The modified program of PCIMT consists of four 1-hour sessions of therapy each week for 4 weeks and 1-2 hours of practice each day at home with a parent or caregiver. Your child will wear a soft splint for constraint 24 hours a day, except for hygiene breaks. Treatment goals will be set based on needs identified collaboratively between the family and the therapist. Treatment will be given in a child-friendly environment and consist of a mix of typical daily activities such as getting dressed and eating along with age-appropriate gross motor play (crawling, climbing) and fine motor play (picking up toys, manipulating objects). Your child will participate in practice and repetition of movements and problem solving and will receive positive praise and reinforcement of desired movements and skills.

How will my child be constrained?

A pre-fabricated wrist and hand splint from Benik will be used. It limits movement in the wrist, hand and fingers of the dominant side. Although it is possible for the splint to be easily removed by a parent or the treating therapist, we ask that it be removed for brief periods only when the child needs to bathe.

Who is eligible for constraint therapy?

In order to participate a child must be one year of age or older and diagnosed with a neuromotor disability that results in one upper extremity being significantly weaker than the other. The child should be medically stable and have no uncontrolled seizures at the time of treatment.

Who do I call if I have questions?

Call Kathy Grinde, PT, at (763)416-8712 to discuss any questions you have regarding our programs.

Information about referrals

All children seen for PCIMT require a physician's order. If you would like your child to be evaluated, we suggest you speak with your primary care physician to discuss if this would be an appropriate treatment for your child.

Who pays for the PCIMT program?

Children's accepts many forms of private insurance, medical assistance and group plans. Because there are many different insurance companies with many different plans, it is your responsibility to understand your child's insurance coverage. We recommend that you call your insurance company to assure coverage.

How do I get an appointment?

Call Kathy Grinde, PT, at (763)416-8712 to coordinate your child's entry into the program.

Learn more at Civitan International Research Center.