Constraint Induced and Bimanual Therapy

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Kennedy Krieger Institute • 707 North Broadway • Baltimore, MD 21205


Joan Carney, Ed. D.

About Our Program:

Since 2004, Kennedy Krieger Institute has offered an intensive pediatric constraint induced movement therapy program based on "best practices" derived from current research in improving upper extremity function for children with paralysis caused by stroke, cerebral palsy or other conditions.

The Constraint Induced and Bimanual Therapy Program consists of one to three hours of therapy per day for approximately four weeks to improve functioning of the more involved upper extremity. During this time, the non-affected upper limb is placed in a cast that goes from above the elbow to the fingertips for the duration of the treatments. The cast is carefully monitored by therapists, family and nursing staff for proper circulation and skin integrity. It is made in a way that it can be easily removed if necessary.

Photo Gallery: Constraint Induced Movement Therapy

Children may be seen individually or in a small group with very individualized therapy. During the summer, a camp-like day program is offered.

At the end of the treatment, a customized home based program is developed and reviewed with the family. Patients are then seen in our follow-up clinic to adjust the home program as needed and to document the outcomes of the therapy.

The therapeutic team includes a physician who specialized in rehabilitation medicine, nurses, occupational and physical therapists and psychologists. Other specialists, including a speech therapist and educator, can be consulted as needed.

Therapy is typically covered by insurance. Our finance specialists can assist in determining this prior to treatment.

Primary Program Goals:

Our therapists work on coaxing the maximal function from the affected limb by using stimulating activities of gradually increasing difficulty. This process is called "shaping" and is based on taking small steps to achieve a specific goal. Abundant positive reinforcement is used every time success is achieved. The goal is to begin use or to increase use of the affected limb rather than ignoring it. Our goal to increase use of the affected arm and hand will allow your child to participate more fully in play, self-care and school activities. We believe that a combination of weakness, increased tone, incoordination and "learned" non-use accounts in large part for the decrease in the ability to use both hands. This program is designed to combat these factors.

Hours of Operation:

The program hours are from 8:30 a.m. - 2:30 p.m., daily. Wednesdays are half days for all patients.


An evaluation to determine whether a child is appropriate for this program can be obtained by scheduling an appointment to see Dr. Frank Pidcock. Please call (443) 923-2600 to schedule this appointment.

Referrals may also be made by community physicians, therapists or the family. Additional information regarding the Constraint-Induced and Bimanual Therapy Program can be obtained by calling the Nurse Clinical Care Manager at (443) 923-4587.

Related Materials and Information
Additional Diagnoses Served: 
Childhood Stroke
In-Utero Strokes
Cerebrovasuclar Accidents
Traumatic Brain Injury
Arterio Venous Malformation