OBJECTIVE: To evaluate the effects of constraint-induced movement therapy on the use of the affected arm and on daily functioning in children with hemiplegic cerebral palsy. DESIGN: A single-blinded randomized clinical trial. SUBJECTS:Sixteen children with cerebral palsy randomized to intervention (n = 8, 4 males, 4 females, mean age 5 years and 6 months) andcontrol groups (n = 8, 4 males, 4 females, mean age 6 years and 7 months). INTERVENTIONS: Non-affected arm of intervention group was restricted for 10 hours/ day and the affected arm intensively trained for 3 hours/day for two weeks. The intervention protocol included one week of bimanual functional training following constraint therapy. The control group maintained usual rehabilitation throughout the intervention period. MAIN MEASURES: Pediatric Evaluation of Disability Inventory (self-care domain) and an adapted version of the Jebsen-Taylor test were administered before and after intervention, and at one month follow-up. General linear models tested differences in gain scores and the number needed to treat estimated relative effectiveness of intervention protocol for functional skills and independence in self-care. RESULTS: Results are reported for 15 children who completed assessments and intervention. Higher gains were observed in the intervention group for functional skills and independence post intervention (d(functional skills) = 1.61, P =0.0134; d(independence)=1.37; P =0.0001) and follow-up (d(functional skills) = 2.08, P =0.004; d(independence) = 0.85; P =0.0016). No group difference in manual dexterity gains was observed. Low indices of number needed to treat (1.75 and 2.33) illustrate clinical relevance of intervention. CONCLUSIONS: The protocol associating constraint-induced movement therapy and bimanual functional training was effective in promoting daily living functioning among children with cerebral palsy.
RCT Entities:
OBJECTIVE: To evaluate the effects of constraint-induced movement therapy on the use of the affected arm and on daily functioning in children with hemiplegic cerebral palsy. DESIGN: A single-blinded randomized clinical trial. SUBJECTS: Sixteen children with cerebral palsy randomized to intervention (n = 8, 4 males, 4 females, mean age 5 years and 6 months) and control groups (n = 8, 4 males, 4 females, mean age 6 years and 7 months). INTERVENTIONS: Non-affected arm of intervention group was restricted for 10 hours/ day and the affected arm intensively trained for 3 hours/day for two weeks. The intervention protocol included one week of bimanual functional training following constraint therapy. The control group maintained usual rehabilitation throughout the intervention period. MAIN MEASURES: Pediatric Evaluation of Disability Inventory (self-care domain) and an adapted version of the Jebsen-Taylor test were administered before and after intervention, and at one month follow-up. General linear models tested differences in gain scores and the number needed to treat estimated relative effectiveness of intervention protocol for functional skills and independence in self-care. RESULTS: Results are reported for 15 children who completed assessments and intervention. Higher gains were observed in the intervention group for functional skills and independence post intervention (d(functional skills) = 1.61, P =0.0134; d(independence)=1.37; P =0.0001) and follow-up (d(functional skills) = 2.08, P =0.004; d(independence) = 0.85; P =0.0016). No group difference in manual dexterity gains was observed. Low indices of number needed to treat (1.75 and 2.33) illustrate clinical relevance of intervention. CONCLUSIONS: The protocol associating constraint-induced movement therapy and bimanual functional training was effective in promoting daily living functioning among children with cerebral palsy.
Authors: Roslyn N Boyd; Jenny Ziviani; Leanne Sakzewski; Laura Miller; Joanne Bowden; Ross Cunnington; Robert Ware; Andrea Guzzetta; Richard Al Macdonell; Graeme D Jackson; David F Abbott; Stephen Rose Journal: BMC Neurol Date: 2013-06-28 Impact factor: 2.474
Authors: Brian J Hoare; Margaret A Wallen; Megan N Thorley; Michelle L Jackman; Leeanne M Carey; Christine Imms Journal: Cochrane Database Syst Rev Date: 2019-04-01
Authors: Carlos Bm Monteiro; Geert Jp Savelsbergh; Ana Rp Smorenburg; Zodja Graciani; Camila Torriani-Pasin; Luiz Carlos de Abreu; Vitor E Valenti; Fernando Kok Journal: Neuropsychiatr Dis Treat Date: 2014-07-03 Impact factor: 2.570