Physical and occupational therapy are initiated early.
Physical therapy aims at keeping the spastic muscles supple and avoiding muscle contracture, as well as exercising weak or paralysed muscles in order to reinforce them. The goal is to prevent deformities and muscle contractures.
Occupational therapy aims at stimulating the use of all muscles, whether spastic or weak, in order to maintain as much function as possible despite the deficit. Bimanual activities are encouraged: pencil and ruler, carrying a tray, bicycle, swimming, bimanual games (computer games, Russian dolls…).
Constraint-induced movement therapy consists in preventing the use of the contralateral normal hand, by fitting it with a splint or a glove, in order to make the patient use exclusively his: her spastic hand. Protocols often involve the CIT therapy three to four hour a day for three to four week periods.
Electrical stimulation (myo feed-back) of the weak or paralysed muscles may help to reinforce these muscles.
