Pediatric CI Therapy - An Interview with Dr. Stephanie C. DeLuca

Pediatric CI Therapy - An Interview with Dr.extremity (52.1% vs 2.1% of items). Benefits
Stephanie C. DeLucawere maintained over 6 months, with
supplemental evidence of quality-of-life changes
As each day passes, medical researchfor many children."
communities strive to find alternative means ofIn the Pediatric Paper Conclusion, "...Pediatric CI
evaluating and treating specific conditions. One oftherapy produced major and sustained
those communities is comprised of a professionalimprovement in motoric function in the young
and highly educated team of PhDs at Alabamachildren with hemiparesis in the study."
University at Birmingham, located in Birmingham,In closing, Pediatric CI Therapy offers a promising
AL. Sharon Ramey, PhD developer and head ofalternative treatment to children with neuromotor
research efforts (of Pediatric CI Therapy) withdisabilities. To learn more about Pediatric CI
co-researchers, Stephanie C. Deluca, PhD, K.Therapy or if you are a Pediatric Practitioner
Echols, PhD., Pt. PCS, and E. Taub, PhD. broadenedwanting to learn how to properly administer
Pediatric CI investigations. PediatricPediatric CI Therapy, please contact Dr. Stephanie
Constraint-Induced Therapy, (also called PediatricC. DeLuca at or through her Website at
CI Therapy) was initiated to further advance© 2004 C. Bailey-Lloyd
treatment in children suffering from neuromotor(Pen Name "Lady Camelot")
disabilities. Funded by a grant from the Alabama© 2004 LadyCamelot
Health Service Foundation, the PediatricC. Bailey-Lloyd currently serves as the Public
Neuromotor Research Clinic was established and isRelations' Director for
now being co-directed by Drs. Echols and DeLuca.Key References:
CI Therapy, also known as "Taub Therapy," was1. Taub, E., Ramey, S., DeLuca, S., Echols, K.,
initially developed by Dr. Edward Taub, Director ofEfficacy of Constraint-Induced Therapy (CI)
Taub Therapy Clinic in Birmingham, AL. A medicalMovement Therapy for Children with Cerebral
innovation that is successful in over 95% ofPalsy, Pediatrics.
stroke patients in helping regain significant2. Pediatric Neuromotor Research Clinic
movement, Taub therapy is an effective stroke3. UAB Health Systems
rehabilitation therapy that consists of restricting4. New Strategies after Stroke: Restraining,
the use of unaffected limbs to "rewire" neurons inRewiring, Relearning
the brain.OTHER PUBLICATIONS
To explore Pediatric CI Therapy, I asked Dr.Echols, K, DeLuca, SC. (submitted). Dosage in the
Deluca a few questions about this particulartreatment of children: Making therapy count.
therapy in an informal interview:Journal of the American Physical Therapy
Q [C.Bailey-Lloyd] Could you explain exactly howAssociation.
the therapy works?DeLuca, S.C., Echols, K., Ramey, S.L. & Taub, E.
A [Stephanie C. DeLuca] The therapy is aimed at(2003). Pediatric constraint-induced movement
children who have asymmetric abilities with theirtherapy for a young child: two episodes of care.
upper extremities because of a lesion within theJournal of the American Physical Therapy
central nervous system. It involves casting theAssociation: 83, 11, 1003-13.
child's stronger arm and hand with a lightweightTaub, E., Ramey, S.L., DeLuca, S.C., Echols, K.
splint which the children wear 24 hours a day for(2004). Efficacy of constraint-induced (CI)
3 weeks. Children are then treated for 6 hoursmovement therapy for children with cerebral
each day for 21 consecutive days.palsy. Pediatrics: 113, 2, 305-12
Q [C. Bailey-Lloyd] What can one expect fromRamey, SL, DeLuca, SC, Echols, K. (2003)
this therapy, and on average, how long isResilience for Today, in E. Grotberg, (Ed).
treatment necessary?Resilience In Families With Children Who Are
A [Stephanie C. DeLuca] This varies from child toExceptional. Greenwood Publishing Group.
child and is dependent on the child's incomingDeLuca, S.C. (2002) Intensive movement therapy
abilities. But children routinely develop numerouswith casting for children with hemiparetic cerebral
new motor abilities with the weaker arm andpalsy: a randomized controlled crossover trial.
hand.Dissertation, University of Alabama at Birmingham.
Q [C.Bailey-Lloyd] How long has this treatmentEchols, K., DeLuca, S.C., Ramey, S., & Taub, E.
been in use and how successful is it?(2002). Constraint-induced movement therapy
A [Stephanie C. DeLuca] We have beenversus traditional therapeutic services for young
implementing this approach for almost 5 yearschildren with cerebral palsy: a randomized
with approximately 65 children and have seencontrolled trial. Developmental Medicine & Child
very dramatic results. But again where childrenNeurology. 44, S 91, 29
end up is dependent on where they start.DeLuca, S.C. (2001) Constraint-induced movement
Q [C.Bailey-Lloyd] Are there any side effects totherapy in pediatrics: a review and case study.
this treatment? Please explainThesis, University of Alabama at Birmingham.
A [Stephanie C. DeLuca] In general there haveEchols, K., DeLuca, S.C., Ramey, S., & Taub, E.
been very few negative side effects. Minor(2001). Constraint-induced Movement therapy in
discomfort with relation to the cast but that isthe child with cerebral palsy. Developmental
usually very transient.Medicine & Child Neurology. 43, S 88, 37
Q [C.Bailey-Lloyd] Who utilizes this therapy (inEchols, K., DeLuca, S.C., Taub, E., Ramey, S.
practice) and how widely is it used across the(2001). Constraint-induced movement therapy in
nation?young children: a protocol and outcomes
A [Stephanie C. DeLuca] We are the only cliniccompared to traditional measures. Pediatric
using the entire protocol that we are aware of.Physical Therapy. 12, 2, 210 Morris, D., Crago, J.E.,
Q [C Bailey-Lloyd] Is this therapy effective onDeLuca, S.C., Pidikiti, R.D., & Taub, E. (1997).
neurological disorders/ diseases other thanConstraint-Induced movement therapy for motor
Cerebral Palsy and Stroke patients?recovery after stroke. NeuroRehabilitation. 9, 29-
A [Stephanie C. DeLuca] That still needs to be43.
addressed with research.Taub, E., Pidikiti, R.D., DeLuca, S.C., Crago, J.E.
On the question of Pediatric CI Therapy(1996). Effects of motor restriction of an
effectiveness opposed to other conventionalunimpaired upper extremity and training on
medical treatments, Dr. DeLuca referred me toimproving functional tasks and altering brain
recently published research efforts in a Pediatricbehaviors. Imaging and Neurologic Rehabilitation.
paper. According to the research team, the133-154.
stated results were"... Children receiving pediatricTaub, E., Crago, J. E., Burgio, L.D., Groomes, T.E.,
CI therapy compared with controls acquiredCook, E.W., DeLuca, S.C., & Miller, N.E. (1994). An
significantly more new classes of motoric skills (9.3operant approach to rehabilitation medicine:
vs 2.2); demonstrated significant gains in the meanOvercoming learned nonuse by shaping. Journal of
amount (2.1 vs 0.1) and quality (1.7 vs 0.3) ofExperimental Analysis of Behavior, 61, 281-293.
more-affected arm use at home; and in a[All work by author is copyright protected. If you
laboratory motor function test displayedwould like to use this article, please contact the
substantial improvement including increases inauthor for permission.
unprompted use of the more-affected upper