Improvement of upper extremity motor control and function after home-based constraint induced therapy in children with unilateral cerebral palsy: Immediate and long-term effects

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

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

37 Scopus citations

Abstract

Objective To investigate the long-term effects of home-based constraint induced therapy (CIT) on motor control underlying functional change in children with unilateral cerebral palsy (CP). Design Randomized controlled trial. Setting Home based. Participants Children with unilateral CP (N=45; aged 6-12y) were randomly assigned to receive home-based CIT (n=23) or traditional rehabilitation (TR) (n=22). Interventions Both groups received a 4-week therapist-based intervention at home. The home-based CIT involved intensive functional training of the more affected upper extremity during which the less affected one was restrained. The TR involved functional unimanual and bimanual training. Main Outcome Measures All children underwent kinematic and clinical assessments at baseline, 4 weeks (posttreatment), and 3 and 6 months (follow-up). The reach-to-grasp kinematics were reaction time (RT), normalized movement time, normalized movement unit, peak velocity (PV), maximum grip aperture (MGA), and percentage of movement where MGA occurs. The clinical measures were the Peabody Developmental Motor Scales, Second Edition (PDMS-2), Bruininks-Oseretsky Test of Motor Proficiency (BOTMP), and Functional Independence Measure for children (WeeFIM). Results The home-based CIT group showed a shorter RT (P<.05) and normalized movement time (P<.01), smaller MGA (P=.006), and fewer normalized movement units (P=.014) in the reach-to-grasp movements at posttreatment and follow-up than the TR group. The home-based CIT group improved more on the PDMS-2 (P<.001) and WeeFIM (P<.01) in all posttreatment tests and on the BOTMP (P<.01) at follow-up than the TR group. Conclusions The home-based CIT induced better spatial and temporal efficiency (smoother movement, more efficient grasping, better movement preplanning and execution) for functional improvement up to 6 months after treatment than TR.

Original languageEnglish
Pages (from-to)1423-1432
Number of pages10
JournalArchives of Physical Medicine and Rehabilitation
Volume95
Issue number8
DOIs
StatePublished - 08 2014

Keywords

  • Cerebral palsy
  • Kinematics
  • Randomized controlled trial as topic
  • Rehabilitation

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