Constraint Induced Therapy for Cerebral Palsy
Neuroscientist Edward Taub has applied CI principles to a number of other disorders. He has begun working with children with cerebral palsy — a complex, tragic disability that can be brought on by damage in the developing brain caused by stroke, infection, lack of oxygen during birth, and other problems.
Taub did a study in which half the children got conventional cerebral palsy rehab and half got CI therapy, with their better-functioning arm placed in a light fiberglass cast. The CI therapy included popping soap bubbles with their affected fingers, pounding balls into a hole, and picking up puzzle pieces. Each time the children succeeded, they were heaped with praise and then, in the next game, encouraged to improve accuracy, speed, and fluidity of motion, even if they were very tired. The children showed extraordinary gains in a three-week training period. Some began to crawl for the first time. An eighteen-month-old was able to crawl up steps and use his hand to put food in his mouth for the first time. One four-and a-half-year-old boy, who had never used his arm or hand, began to play ball.
When Frederick was seven months old, he had a seizure. The entire left side of his body was affected: his arm and leg didn't function well and his left arm was drawn up to his chest and couldn't be pulled away. His eye drooped, and he couldn't form sounds or words because his tongue was partially paralyzed. Frederick couldn't crawl or walk when other children did. He couldn't talk until he was three.
He was given an MRI brain scan that, the doctor told his mother, showed that "one-quarter of his brain was dead," and that "he would probably never crawl, walk, or talk." The doctor believed the stroke had occurred about twelve weeks after Frederick was conceived. He was diagnosed with cerebral palsy, with paralysis on the left side of his body.
By the time he went to Taub's clinic, Frederick was four. He had made some progress using conventional approaches. He could walk with a leg brace and could talk with difficulty, but his progress had plateaued. He could use his left arm but not his left hand. Because he had no pincer grasp and couldn't touch his thumb to any of his fingers, he couldn't pick up a ball and hold it in his palm. He had to use the palm of his right hand and the back of his left.
A mere nineteen days into the therapy, "lefty" developed a pincer grasp. "Now," says his mother, "he can do anything with that left hand, but it is weaker than the right.
Frederick is now eight, and he doesn't think of himself as disabled. He can run. He plays a number of sports, including volleyball, but he has always loved baseball best.
Frederick's progress has been phenomenal. He tried out for the regular baseball team — not one for handicapped children — and made the cut. "He played so well on the team," says his mother, "that he was chosen by the coaches for the all-star team.
Excerpted from the book: The Brain That Changes Itself
Stories of Personal Triumph from the Frontiers of Brain Science
By Norman Doidge, MD, Penguin Publishing, December, 2007