Is outcome of constraint‐induced movement therapy in unilateral cerebral palsy dependent on corticomotor projection pattern and brain lesion characteristics?

Abstract

ABBREVIATIONS AHAAssisting , and the Melbourne Assessment, both before and after the day camp. Transcranial magnetic stimulation was used to explore the corticomotor organization, and brain lesion characteristics were described by visual assessment of conventional structural magnetic resonance images.RESULTS At a group level, the training was associated with significant improvements in JTHFT (p=0.003) and AHA (p=0.046), but not in Melbourne Assessment scores. Improvements were found in all types of corticomotor projection patterns, i.e. contralateral, mixed, and ipsilateral. There was no relationship between functional improvement and brain lesion characteristics.

Resting State and Diffusion Neuroimaging Predictors of Clinical Improvements Following Constraint-Induced Movement Therapy in Children With Hemiplegic Cerebral Palsy

“…This asymmetric unilateral sensorimotor network organization was observed in most subjects, regardless of lesion volume, suggesting that injury location rather than size is more relevant to motor impairment. 21 Our novel finding is that subjects with a resting state network deemed more asymmetric according to laterality indices based on these altered connectivity patterns tended to improve the most according to both the change in Canadian Occupational Performance Measure score and the time to complete the Jebsen-Taylor task, whereas subjects with more symmetric and bilateral baseline sensorimotor network organization showed the least improvement. The mechanism of constraint therapy may be optimally linked with the opportunity to restore bilateral connectivity.…”

Less-Affected Hand Function in Children With Hemiparetic Unilateral Cerebral Palsy: A Comparison Study With Typically Developing Peers

“…Other data suggest the patterns of motor representation is not indicative of responsiveness to intervention. 12,24 Further examination of the neurophysiological relationship between baseline motor pattern and the components of intervention is critical for the design of individualized interventions in the future.…”

Improvements in bimanual hand function after baby-CIMT in two-year old children with unilateral cerebral palsy: A retrospective study

“…The impact of brain lesion on intervention outcome is rarely considered. One study demonstrates that one block of CIMT at age 2-3 years can predict better longitudinal development of bimanual hand use, but this treatment effect diminishes when controlling for brain lesion and baseline ability (Eliasson & Holmefur, 2014); in other studies of older children, the results are inconclusive (Islam et al, 2014;Kuhnke et al, 2008). The present retrospective cohort design including only one measure of the children's hand function could be seen as a weakness, because it does not establish a causal effect to the extent of an experimental design.…”