ArticleThe American journal of occupational therapy : official publication of the American Occupational Therapy Association2026
Development of a Practical Guide for Pediatric Constraint-Induced Movement Therapy: Enhancing Understanding and Informed Decision-Making.
Article in The American journal of occupational therapy : official publication of the American Occupational Therapy Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
importanceConstraint-induced movement therapy (CIMT) is an intervention for hemiplegic cerebral palsy (CP) that has a strong evidence base. CIMT has been shown to be effective in improving functional use of the more impaired upper extremity, yet has not become standard practice. Toolkits have been effectively used in various settings to increase intervention implementation; however, no guide currently exists to support clinical decision-making related to CIMT.
objectiveTo provide an overview of the development of a practical guide for pediatric CIMT (pCIMT) that will aid therapists, other health care professionals, and families with children who may be eligible for pCIMT.
designModel development research.
settingVirtual communication secured in accordance with the Health Insurance Portability and Accountability Act of 1996 (Pub. L. 104-191).
participantsContent experts (N = 12) with expertise related to pCIMT, hemiplegic CP, and occupational therapy who were recruited via purposive sampling to develop the practical guide. OUTCOMES AND MEASURES: Development of the practical guide followed a toolkit developmental model. Field notes were used to record all verbal and written feedback provided by content experts.
resultsThe participants provided recommendations to include in the guide during the developmental phase. In two rounds of the expert review phase, they recommended revisions related to readability, content, and visuals. The final practical guide included six sections. CONCLUSIONS AND RELEVANCE: A practical guide was developed to support occupational therapists, health care professionals, and caregivers in making an informed decision about whether pCIMT is the right intervention for a particular child. Plain-Language Summary: Hemiplegic cerebral palsy is the most common motor disability that affects children, and it often causes difficulty moving one side of the body. Pediatric constraint-induced movement therapy (pCIMT) is an evidence-based intervention to help children use their more affected side. However, pCIMT is not widely available. With guidance from key informants, we designed a practical guide to support health care professionals and families in determining whether pCIMT could be an appropriate intervention. A three-phase toolkit development model was followed to design the practical guide. In this article, we report on Stages 1 and 2 (the development and expert review phases). Twelve experts and caregivers informed the development of the six sections of the practical guide. Future research should proceed to Stage 3 (the evaluation phase) to evaluate the effectiveness of the practical guide and identify implementation strategies for the guide to support pCIMT usage.
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