Randomized Trial of Modified Constraint-Induced Movement Therapy With and Without an Intensive Therapy Program in Children With Unilateral Cerebral Palsy

Abstract

The combination of m-CIMT with an intensive therapy program on distal hand function and strength enhances the effects of m-CIMT alone for improving bimanual performance.

Measuring changes of manual ability with ABILHAND‐Kids following intensive training for children with unilateral cerebral palsy

“…24 In the present study, a difference in responsiveness was observed between the two age groups (i.e. While it has previously been suggested that older children may encounter reduced changes because of less plasticity of the brain, notably during CIMT, 26,27 opposite findings were proposed by Sakzewski et al, 28 suggesting that best responders were older children. One possible explanation, consistent with the general idea of the 'Kennard Principle', 25 might be that neuroplasticity is lower in adolescents and that less manual ability improvement can be obtained in this group over a 2 to 3 weeks' intervention in comparison to younger children.…”

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

“…"Modified constraint induced movement therapy (mCIMT)" (Hoare, Imms, Villanueva, Rawicki, Matyas, & Carey, 2013;Klingels et al, 2013;Wallen, Ziviani, Naylor, Evans, Novak, & Herbert, 2011 …”

“…Home programs were provided in 31 (52%) of studies however only 7 (23%) provided adequate description to replicate the programs or details on how to obtain the program from authors. 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.…”

“…workshops) was reported in 17 studies (28%), however, no study reported adequate details about the content or structure of training, whether there were training materials or where these could be accessed. A further 10 studies (17%) reported having procedure manuals, generic or standardized task specific therapy protocols Duncan, Shen, Zou, Han, Lu, Zheng et al, 2012;Fehlings, Rang, Glazier, & Steele, 2000;Gordon et al, 2011;Kawamura, Campbell, LamDamji, & Fehlings, 2007;Klingels et al, 2013;Olesch, Greaves, Imms, Reid, & Graham, 2010;Rameckers, Speth, Duysens, Vles, & Smits-Engelsman, 2009;Speth, Leffers, JanssenPotten, & Vles, 2005) to guide clinicians in the provision of therapy, however only three provided details that the protocols could be accessed on request (Duncan et al, 2012;Olesch et al, 2010;Sakzewski et al, 2015).…”

Neurophysiological mechanisms and functional impact of mirror movements in children with unilateral spastic cerebral palsy

“…24,25 Intensive hand therapy is costly and typically requires a great amount of time and family commitment. constraint-induced movement therapy (CIMT) or intensive bimanual therapy) has been shown to be effective in improving children's hand function at a group level, there is high variability in outcomes among individuals.…”