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

Efficacy of Modified Constraint-induced Movement Therapy in Children With Brain Damage: Evidence of Kinematic Study

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.

Home based CIT Restriction of the less affected limb Intensive practice using affected limb Positive experience Functional task (task)

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.

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.

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