Effect of therapist-based constraint-induced therapy at home on motor control, motor performance and daily function in children with cerebral palsy: A randomized controlled study

Chia Ling Chen, Lin Ju Kang, Wei Hsien Hong, Fei Chuan Chen, Hsieh Ching Chen, Ching Yi Wu*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

31 Scopus citations

Abstract

Objective: To determine the effect of therapist-based constraint-induced therapy at home on motor performance, daily function and reaching control for children with cerebral palsy. Design: A single-blinded, randomized controlled trial. Subjects: Forty-seven children (23 boys; 24 girls) with unilateral cerebral palsy, aged 6-12 years, were randomized to constraint-induced therapy (n = 24) or traditional rehabilitation (n = 23). Interventions: Constraint-induced therapy involved intensive functional training of the more affected arm while the less affected arm was restrained. Traditional rehabilitation involved functional unilateral and bilateral arm training. Both groups received individualized therapist-based interventions at home for 3.5-4 hours/day, two days a week for four weeks. Main measures: Motor performance and daily function were measured by the Peabody Developmental Motor Scale, Second Edition and the Pediatric Motor Activity Log. Reaching control was assessed by the kinematics of reaction time, movement time, movement unit and peak velocity. Results: There were larger effects in favour of constraint-induced therapy on motor performance, daily function, and some aspects of reaching control compared with traditional rehabilitation. Children receiving constraint-induced therapy demonstrated higher scores for Peabody Developmental Motor Scale, Second Edition - Grasping (pretest mean ± SD, 39.9 ± 3.1; posttest, 44.1 ± 2.8; P < 0.001), Pediatric Motor Activity Log (pretest, 1.8 ± 0.3; posttest, 2.5 ± 0.3; P < 0.001) and shorter reaction time, normalized movement time (P < 0.001) and higher peak velocity (P = 0.004) of reaching movement. Conclusions: Constraint-induced therapy induced better grasping performance, daily function, and temporal and spatiotemporal control of reaching in children with unilateral cerebral palsy than traditional rehabilitation.

Original languageEnglish
Pages (from-to)236-245
Number of pages10
JournalClinical Rehabilitation
Volume27
Issue number3
DOIs
StatePublished - 03 2013

Keywords

  • Constraint-induced therapy
  • cerebral palsy
  • daily function
  • motor performance
  • randomized controlled trial

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