An ecological approach of Constraint Induced Movement Therapy for 2–3-year-old children: A randomized control trial

Eliasson, Ann‐Christin; Shaw, Karin; Berg, Elisabeth; Krumlinde‐Sundholm, Lena

doi:10.1016/j.ridd.2011.05.024

Cited by 84 publications

(155 citation statements)

References 31 publications

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“…Home programs were variously described as lists of activities, manual of exercises (Klingels et al, 2013), home program with neurodevelopmental activities (Law, Cadman, Rosenbaum, Walter, Russell, & Dematteo, 1991;Law, Russell, Pollock, Rosenbaum, Walter, & King, 1997) or written lists of training tasks (Taub, Griffin, Uswatte, Gammons, Nick, & Law, 2011). Four studies provided details of the content and structure of the home program (Aarts et al, 2012;Abd El-Kafy et al, 2014;Deppe et al, 2013;Eliasson, Shaw, Berg, & Krumlinde-Sundholm, 2011), three described commercially available video or web-based games (Chiu et al, 2014;James et al, 2015;Zoccolillo et al, 2015) and the remaining studies had inadequate details to replicate either the structure or content of the home program.…”

Section: Research Interventionsmentioning

confidence: 99%

Do we really know what they were testing? Incomplete reporting of interventions in randomised trials of upper limb therapies in unilateral cerebral palsy

Sakzewski

Reedman

Hoffmann

2016

Research in Developmental Disabilities

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Background: Incomplete reporting of components of interventions limits uptake of evidence into clinical practice. Aims:To evaluate the completeness of reporting of research and control interventions in randomised trials of upper limb therapies for children with unilateral cerebral palsy. Methods and procedures:Sixty randomized trials were included, encompassing 60 research and 68 control interventions. Using the 12-item Template for Intervention Description and Replication (TIDieR) checklist, two reviewers independently rated intervention and control descriptions.Outcomes and results: When using 50% of studies as the benchmark, five of the 12 TIDieR items for the research intervention, eight of the 12 items for the control intervention and 11 of 12 items for "usual care" interventions were inadequately reported. Procedures used to deliver the research intervention were adequately reported for 63% of studies. Materials were used in 94% of research interventions, yet only 27% provided details to access/replicate materials. Training materials for interventionists were used in 38% of trials, 10 (17%) had procedure manuals, yet only 3 reported details to access materials. The location where the research intervention was provided was detailed in 65% of studies. Reporting of all items was poorer for the control intervention. Conclusions:No study adequately reported all elements on the TIDieR checklist. Details crucial for replication of interventions and interpretation of results were missing. Authors, reviewers, and editors all have a responsibility to improve the quality of intervention reporting in published trials. The TIDieR guide is a potential solution, helping to structure accounts of interventions. What this study adds:This is the first study 3  This is the first study to evaluate the completeness of reporting of intervention components in complex cerebral palsy interventions  This is the first study to rate completeness of reporting of control interventions  This study provides information to increase awareness of editors, reviewers and authors of the importance of complete reporting of intervention components in cerebral palsy rehabilitation.

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Section: Research Interventionsmentioning

confidence: 99%

Do we really know what they were testing? Incomplete reporting of interventions in randomised trials of upper limb therapies in unilateral cerebral palsy

Sakzewski

Reedman

Hoffmann

2016

Research in Developmental Disabilities

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“…1,2 The effect is maintained for at least 6 months after the therapy ends [3][4][5][6][7] and has been reported to last for up to 1 year. [8][9][10] Because the ultimate goal of treatment is to change the natural course of motor development in a lifetime perspective, it is important to investigate the long-term effect of mCIMT.…”

Section: Resultsmentioning

confidence: 96%

“…3,4 For a subgroup of children we also have information about the basic pattern of brain damage. Because of the importance of understanding the long-term effect of mCIMT, it was of interest to undertake a secondary analysis of these previously collected data.…”

Section: Resultsmentioning

confidence: 99%

“…11,12 All of the children had been involved in usual treatment before the data collection for this study. Twenty-six children had undergone one block of mCIMT 3,4 and 19 children participated as the reference group (i.e. no mCIMT).…”

Section: Participantsmentioning

confidence: 99%

“…In a previous study of longitudinal development, 11 about half of the children had been involved in an mCIMT programme (2h of daily training over 8wks) at around 2 to 3 years of age and the therapy had had a positive effect. 3,4 For a subgroup of children we also have information about the basic pattern of brain damage. Because of the importance of understanding the long-term effect of mCIMT, it was of interest to undertake a secondary analysis of these previously collected data.…”

mentioning

confidence: 99%

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The influence of early modified constraint‐induced movement therapy training on the longitudinal development of hand function in children with unilateral cerebral palsy

Eliasson

Holmefur

2014

Develop Med Child Neuro

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AHAAssisting Hand Assessment MCA Middle cerebral artery mCIMT Modified constraint-induced movement therapy WDMI White matter damage of immaturity AIM There is evidence that modified constraint-induced movement therapy (mCIMT) has a short-term positive effect on hand function in children with unilateral cerebral palsy (CP), but the long-term effect is unknown. The aim of this study was to investigate whether or not a single block of mCIMT (2h/d for 2mo) at age 2 to 3 years influences the course of development of bimanual hand function at around 8 years of age.METHOD A convenience sample of 45 children (24 males, 21 females) with unilateral CP and mean (SD) age at first assessment 32 months (13mo) was included in this study. The participants were divided into the mCIMT group (n=26) and the reference group (no mCIMT; n=19). Brain lesion characteristics were available for 32 children. The children were measured repeatedly with the Assisting Hand Assessment (AHA) for a mean period of 4 years and 6 months. Development curves were created and compared with a non-linear mixed effects model. RESULTSChildren who were receiving mCIMT had an upper limit of development of bimanual hand function that was 8.5 AHA units higher than in the reference group (p=0.022). However, when controlling for brain lesion characteristics and baseline in a subgroup of 32 children, the difference was considerably smaller and no longer significant.CONCLUSION mCIMT may have a positive impact on long-term development of bimanual hand function, but the results are inconclusive and further research is necessary.There is evidence from higher-level studies that modified constraint-induced movement therapy (mCIMT) is effective at improving hand function in children with unilateral cerebral palsy (CP). 1,2 The effect is maintained for at least 6 months after the therapy ends 3-7 and has been reported to last for up to 1 year. [8][9][10] Because the ultimate goal of treatment is to change the natural course of motor development in a lifetime perspective, it is important to investigate the long-term effect of mCIMT. 9The possible long-term impact of mCIMT is of great importance not only for children and their families, but also for health care providers when prioritizing and organizing resources. According to a recent consensus report, the long-term impact of this therapy has also been identified as one of the very important questions to explore in future research.9 Longer-term follow-up is complicated, however, because outcomes are susceptible to influences from other treatments and ongoing development. Further, it is questionable whether one block of mCIMT at an early age can be expected to have a notable impact after several years.We have previously shown that the Assisting Hand Assessment (AHA) measure at 18 months of age can predict both the rate and the ability limit of development. The most dramatic development of hand function occured in the early preschool period (before age 3y), at least in the case of the most able children, who spontaneously u...

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Changes Induced by Early Hand-Arm Bimanual Intensive Therapy Including Lower Extremities in Young Children With Unilateral Cerebral Palsy

Araneda,

Ebner-Karestinos,

Paradis

et al. 2024

JAMA Pediatr

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ImportanceIntensive interventions are provided to young children with unilateral cerebral palsy (UCP), classically focused on the upper extremity despite the frequent impairment of gross motor function. Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) effectively improves manual dexterity and gross motor function in school-aged children.ObjectiveTo verify if HABIT-ILE would improve manual abilities in young children with UCP more than usual motor activity.Design, Setting, and ParticipantsThis prospective randomized clinical trial (November 2018 to December 2021), including 2 parallel groups and a 1:1 allocation, recruitment took place at European university hospitals, cerebral palsy specialized centers, and spontaneous applications at 3 sites: Brussels, Belgium; Brest, France; and Pisa, Italy. Matched (age at inclusion, lesion type, cause of cerebral palsy, and affected side) pairs randomization was performed. Young children were assessed at baseline (T0), 2 weeks after baseline (T1), and 3 months after baseline (T2). Health care professionals and assessors of main outcomes were blinded to group allocation. At least 23 young children (in each group) aged 12 to 59 months with spastic/dyskinetic UCP and able to follow instructions were needed. Exclusion criteria included uncontrolled seizures, scheduled botulinum toxin injections, orthopedic surgery scheduled during the 6 months before or during the study period, severe visual/cognitive impairments, or contraindications to magnetic resonance imaging.InterventionsTwo weeks of usual motor activity including usual rehabilitation (control group) vs 2 weeks (50 hours) of HABIT-ILE (HABIT-ILE group).Main Outcomes and MeasuresPrimary outcome: Assisting Hand Assessment (AHA); secondary outcomes: Gross Motor Function Measure-66 (GMFM-66), Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT), and Canadian Occupational Performance Measure (COPM).ResultsOf 50 recruited young children (26 girls [52%], median age; 35.3 months for HABIT-ILE group; median age, 32.8 months for control group), 49 were included in the final analyses. Change in AHA score from T0 to T2 was significantly greater in the HABIT-ILE group (adjusted mean score difference [MD], 5.19; 95% CI, 2.84-7.55; P &lt; .001). Changes in GMFM-66 (MD, 4.72; 95% CI, 2.66-6.78), PEDI-CAT daily activities (MD, 1.40; 95% CI, 0.29-2.51), COPM performance (MD, 3.62; 95% CI, 2.91-4.32), and satisfaction (MD, 3.53; 95% CI, 2.70-4.36) scores were greater in the HABIT ILE group.Conclusions and RelevanceIn this clinical trial, early HABIT-ILE was shown to be an effective treatment to improve motor performance in young children with UCP. Moreover, the improvements had an impact on daily life activities of these children.Trial registrationClinicalTrials.gov Identifier: NCT04020354

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An ecological approach of Constraint Induced Movement Therapy for 2–3-year-old children: A randomized control trial

Cited by 84 publications

References 31 publications

Do we really know what they were testing? Incomplete reporting of interventions in randomised trials of upper limb therapies in unilateral cerebral palsy

Do we really know what they were testing? Incomplete reporting of interventions in randomised trials of upper limb therapies in unilateral cerebral palsy

The influence of early modified constraint‐induced movement therapy training on the longitudinal development of hand function in children with unilateral cerebral palsy

Changes Induced by Early Hand-Arm Bimanual Intensive Therapy Including Lower Extremities in Young Children With Unilateral Cerebral Palsy

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