Efficacy of Modified Constraint-induced Movement Therapy in Children With Brain Damage

Chang Gung Memorial Hospital48 enrolled

Overview

This research centers on the comparison of the immediate efficacy (right after therapy) and the maintained efficacy (3 months and 6 months) between "Modified Constraint-Induced Movement Therapy" (mCIMT) group and control group at different age.

"Modified Constraint-Induced Movement Therapy" is one of the most recent treatments for children with Brain damage. This well-designed and follow-up RCT study compared home-based CIT with a control intervention (traditional rehabilitation, TR) by combining kinematic analysis and clinical evaluation, which is possible to examine whether functional improvement is accompanied by a change in motor control. We hypothesized that home-based CIT would induce better motor control strategies (shorter RT, MT, lesser MUs, MGA, and PMGA, and larger peak velocity (PV)) for greater functional gains than TR. Furthermore, the beneficial effects would be maintained at 3 and 6 months of follow-up. Findings of this study allow clinicians to understand the underlying motor control changes for functional improvement after home-based CIT.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Brain Damage Cerebral Palsy Traumatic Brain Damage

Interventions

Modified Constraint-induced Movement TherapyBEHAVIORAL

Home based CIT 1. Restriction of the less affected limb 2. Intensive practice using affected limb 3. Positive experience 4. Functional task (task)

Eligibility

Sex: ALLMin age: 4 YearsMax age: 15 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Development learned-nonuse 2. Age range 4y/o-15y/o 3. Wrist ext 10˚, MP j't ext 10˚ in affected U/E 4. Can fallow up the simple instruction 5. Modified Ashworth Scale ≦2 6. Pediatric Motor Activity Log ≦2.5 (average) Exclusion Criteria: 1. Related muscle skeleton surgery 2. Selective dorsal rhizotomy 3. Botulinum toxin in 6 months 4. Visual perception impaired 5. Hearing perception impaired 6. Balance ability impaired (in constrained)

Locations (1)

Chang Gung Memorial Hospital

Taoyuan District, Taoyuan, Taiwan

Outcomes

Primary Outcomes

Bruininks-Oseretsky Test of Motor Proficiency (BOTMP)

All children underwent a series of upper limb assessments, including kinematic analysis and functional measures (primary and secondary outcomes), before the start of the intervention (pretreatment). An occupational therapist blinded to group assignment was trained to administer these measures. All participants underwent these assessments at 4 weeks immediately after intervention (post-treatment), and at 12-week follow-up and 24-week follow-up.