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As physical, occupational and speech therapists working with children with complex needs (and too often) exhausted families and disconnected teams that don't always see eye-to-eye, we recognised the need for clinical discussions that go beyond what we can gather from textbook and published guidelines.

Dr Brian Hoare: CIMT & Bimanual Therapy in Cerebral Palsy

Kim Barthel Occupational Therapy for pediatric therapists

Scroll down for the podcast and links to all good things discussed in the interview

Dr Brian Hoare is an occupational therapist from Australia, probably known best for his contributions to the field of CIMT and bimanual training in children with unilateral cerebral palsy. At the time of this interview he had more than 34 publications (including 2 Cochrane Reviews and an RCT) under his belt and some cutting edge research underway. Brian is passionate about bridging the gap between research and clinical practice through his company CPteaching. He has a highly specialized clinic for children with unilateral cerebral palsy where he continues to work as a clinician and in his spare time (apparently he still has some) he has developed and maintains his own iPhone App, CPtoys.

Scroll down to the podcast player to listen or find us on iTunes or Stitcher.

There was so many things we covered in this interview that we couldn't cover everything in depth. If you'd like to dig a bit deeper into these topics, scroll down to the Resources Section to find the links

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The Podcast: Listen, enjoy, share...

If you have a slow internet connection, you may need to download the podcast first by clicking on the download symbol (the little down arrow) in the player below or find us on iTunes or Stitcher

Time Stamps (drag the cursor along the sound wave - might only work on desktop)

  • The beginnings of Botox in the upper limb 7:58

  • Developing skills in treating unilateral Cerebral Palsy 10:10

  • Balancing roles: Clinician vs Academic 11:55

  • CP Teaching 14:42

  • Core Philosophies and Task Based Training 16:26

  • The A-ha moment with Lena Krumlinde-Sundholm and the AHA and functional hand use 18:12

  • CIMT vs Bimanual Therapy 21:04

  • Intensive Therapy does not always win - there's more to learn 25:30

  • When research doesn't give you the outcomes you expect 27:16

  • Implicit and explicit learning 28:00

  • Knowing when to choose CIMT or Bimanual therapy 29:30

  • Baby Constraint Therapy and Distributed Models of CIMT 31:57

  • Therapy at home vs therapy in the clinic 33:04

  • Why different skill set is needed for Bimanual therapy 34:56

  • Dosage and other tips for home exercises 35:57

  • Therapy at home vs therapy in the clinic 33:04

  • Therapy Blocks and working in teams 37:27

  • Questions

  • Repeating CIMT block of treatment with an 8 year old 39:47

  • Why you have to progress to Bimanual Therapy 41:29

  • Switching from Bimanual Therapy back to CIMT 42:47

  • Next steps after CIMT and Bimanual 34:12

  • Goal Directed Training 45:15

  • Optimal age for starting with CIMT 47:20

  • Botox efficacy 48:33

  • Managing stiffness 53:24

  • Long term functional benefits of Botox 54:05

  • How early to use Botox 56:06

  • Splinting 58:52

  • Botox efficacy 58:33

  • When is CIMT not recommended 1:02:57

  • FES in hemiplegia 1:04:33

  • Who / What is currently noteworthy 1:06:14

  • Best advice for new therapists 1:09:07


Wired ON Development clickable links to great resources

Dr Brian Hoare's Websites:

Please note: book links go through to Amazon Affiliate Program

Thanks for your support!

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