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How constraint therapy gives Brinley more independence

“She wasn’t supposed to do any of this, but now she’s doing it all.”

Brinley holding up a sign that says Brinley Pre-K
Photography by Kelsey Anne Photography

Brinley loves playing with her two sisters. She also enjoys helping with chores around the house — like laundry and dinner. Those everyday activities didn’t come naturally to the witty and energetic 4-year-old. Brinley has quadriplegic cerebral palsy (CP), a disorder of the brain that affects her ability to control her muscles and coordinate body movements. She’s learning how to move more independently with constraint induced movement therapy at Children’s Minnesota. Trust us — don’t let the name put you off!

Birth and diagnosis

Brinley was born 10 weeks premature and spent a month at another hospital before being transferred to the neonatal intensive care unit (NICU) at Children’s Minnesota. She was finally healthy enough to go home after two months. However, Brinley’s mom, Nicole, knew when she was born there was a high chance of her daughter having other health issues.

When Brinley was about 14 months old she wasn’t able to rollover, crawl or sit. Brinley was diagnosed with quadriplegic CP. Though all four of her limbs are affected, she has more weakness in her right arm and leg. “She could not raise her arm to give a high-five. It’s almost like she didn’t know she had a right arm,” described Nicole.

Physical therapy at Children’s Minnesota

Physical therapy is an important treatment for kids with CP. Physical, occupational or speech therapy helps them develop skills like walking, sitting, swallowing and using their hands. Brinley started constraint induced movement therapy (CIMT) at another health care system closer to the family’s home in Alexandria, Minnesota. However, the family felt like they were left to do most of the treatment on their own.

“They didn’t do specialized therapy. They put a cast on Brinley and we were sent on our way. Where at Children’s Minnesota, they actually work with her on everyday activities while she’s casted, which is a huge difference,” says Nicole.

Pediatric constraint induced movement therapy is a program to improve movement and strength in a child who has more weakness on one side of the body. A constraint, typically a cast, is put on the stronger arm and hand to limit movement during treatment. This encourages more movement of the weaker arm and hand.

Brinley and physical therapistChildren’s Minnesota offers a full and modified CIMT program. The full program was started by two physical therapists, but has grown to include several occupational therapists as well. The full program is six hours of therapy each day for 20 days over four weeks. The modified program consists of eight hours of therapy per week over three weeks. Even though that sounds like a lot of time — that’s why it works!

“They sat with Brinley for hours and taught her. That’s what I really like and enjoy about the therapists and the program,” said Nicole.

Brinley has also improved her walking through the gait clinic. This program involves a comprehensive evaluation of how a child walks and makes recommendations for improving the child’s efficiency and independence with walking. They collaborate closely with an orthotist to find the optimal foot or leg brace for the child to use as well.

“Brinley wasn’t supposed to do any of this, we were basically told she may never walk,” said Nicole. “Well, she’s doing it all and that’s all because of the teams at Children’s Minnesota.”

‘They lift you up’

Brinley went through the modified CIMT program in 2020 with a team of therapists led by Kathy Grinde, a physical therapist at the Children’s Minnesota Clinic in Maple Grove. Nicole was amazed at the results.

“Brinley was able to actually utilize her right side. She will now point with her right arm if the object is on her right side — this is huge.”

Mom is learning too! Nicole can watch Brinley’s sessions so they can keep the learning going at home.

“They lift you up. Their feedback on what we do at home is encouraging and lets us know we are on the right path,” said Nicole.

This fall, Brinley is going through the full CIMT program with the goal of even more and lasting improvements and independence. Nicole believes none of Brinley’s progress would be possible without The Kid Experts™ at Children’s Minnesota.

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