Dose Characteristics of Constraint-Induced Movement Therapy for Fine Motor Function in Children with Cerebral Palsy

Abstract

Background: Constraint-induced movement therapy (CIMT) is used to improve upper limb function in children with cerebral palsy (CP), but treatment protocols vary substantially in duration, frequency, intensity, and type of constraint.
Objective: To synthesize evidence on CIMT dose characteristics and fine motor outcomes in children with CP.
Methods: A systematic review was conducted using PubMed, ScienceDirect, and Google Scholar. Randomized controlled trials, systematic reviews, and meta-analyses published between 2016 and 2026 were eligible. Six primary studies and two secondary evidence syntheses were included. Fine motor outcomes included grasping, visual motor integration, manual dexterity, and hand function. Evidence was synthesized narratively because of substantial heterogeneity.
Results: CIMT protocols ranged from 30 minutes to 6 hours daily, 3 to 6 sessions weekly, and 2 to 12 weeks. Some studies reported greater improvement with higher intensity, whereas others reported more favorable outcomes with lower daily duration distributed over longer periods. Comparative findings were inconsistent. Secondary evidence suggested potential benefits for upper limb function but did not establish total dose as a consistent determinant of treatment effect.
Conclusion: CIMT may improve selected fine motor and hand function outcomes in children with CP. However, heterogeneity in intervention protocols, comparators, outcome measures, and study quality prevents identification of an optimal dose. Further standardized trials are needed.