Cerebral palsy in adult patients: constraint-induced movement therapy is effective to reverse the nonuse of the affected upper limb

Oliveira, Ana Cecília P.; Freitas, Camila de; Garcia, Rafael Eras; Matuti, Gabriela da Silva; Santos, Juliana Firmo dos; Oliveira, Clarissa Barros de

doi:10.1590/0004-282x20150195

Cited by 3 publications

(1 citation statement)

References 16 publications

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“…4,5) In patients with CP, the effectiveness of CIMT has been reported. 6,7) CIMT consists of intensive and repetitive exercise using only the affected upper limb while the non-affected upper limbs are constrained. However, whether patients are able to perform CIMT by grasping, transporting, and releasing objects using only the affected hand depends on the remaining function of the affected hand.…”

Section: Introductionmentioning

confidence: 99%

Voluntary-assisted Upper Limb Training for Severe Cerebral Palsy Using Robotics Devices and Neuromuscular Electrical Stimulation: Three Case Reports

Kuroda

Iwasaki

Yoshikawa

et al. 2022

PRM

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Background: Constraint-induced movement therapy (CIMT) improves the motor function of paralyzed upper limbs of adults after stroke. However, in patients with severe spastic cerebral palsy (CP), the use of CIMT is not warranted. Our aim was to investigate the feasibility and effectiveness of repetitive voluntary-assisted upper limb training (VAUT) for three patients with severe CP using a combination of robotics [Hybrid Assistive Limb (HAL)] and functional electrical stimulation [Integrated Volitional Control Electrical Stimulation (IVES)]. Case: Three patients with CP were enrolled. Patients 1, 2, and 3 were 8-, 19-, and 18-year-old males, respectively. Patient 1 had spastic hemiplegia, while patients 2 and 3 had spastic quadriplegia. VAUT using single-joint HAL was performed for 1 or 2 sessions/month for 50 min/session over an 8-month period for 9-13 sessions in total. One patient's voluntary hand movement was insufficient, affecting his upper limb exercise performance; therefore, IVES was required in addition to HAL. Outcome measures included motor function of the upper limbs and use of paralyzed hands, which were measured before and after intervention. No adverse events were observed during VAUT. After intervention, the Action Research Arm Test scores showed improvements in all three patients. The Children's Hand-use Experience Questionnaire showed improvements in two patients. Discussion: The use of VAUT, together with new systems such as HAL and IVES, for severe CP is safe and may be effective. Our study suggested that upper limb function can be improved for patients with severe CP.

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Section: Introductionmentioning

confidence: 99%