Constraint induced movement therapy in hemiplegic cerebral palsy: a national survey of its use by physiotherapists in the UK

Background/aims: There is an emerging evidence base into the use of Constraint Induced Movement Therapy (CIMT) in hemiplegic Cerebral Palsy (CP). However, there is little evidence of its use in the UK. This study aimed to conduct a national survey of physiotherapists to explore their use of CIMT in hemiplegic CP and to identify barriers and facilitators to its use. Methods: An online survey was distributed to members of the Association of Paediatric Chartered Physiotherapists (APCP) within the UK. At this time, there were approximately 2300 members on the professional database. Participants were asked about their experience and views regarding CIMT use/training, including their beliefs regarding delivery of CIMT in the UK health system. Findings: Responses were from 121 therapists from 12 regions of the UK, working across the National Health Service, private sector and education; based in inpatient, outpatient, community and school settings. Fifty three percent had never used CIMT although 73.6% felt it was an appropriate treatment. Most therapists felt they did not have enough training to use CIMT. Barriers included ethical issues, resources and training. Facilitators to its use included treatment modification, support of others and outcome appraisal. The ethical and legal ramifications of restraint were a common concern which prevented therapists from using CIMT. Family compliance influenced therapists’ decision to use CIMT. Conclusions: There is evidence to suggest physiotherapists in the UK are using CIMT to some extent in this patient group and that there is established clinical interest. Further research is needed to clarify ethical and legal ramifications of restraint