Constraint-induced movement therapy for children with neonatal brachial plexus palsy: a randomized crossover trial
| Autor: | Jennifer Loiselle, Julie M Werner, Jamie Berggren, Gina Kim Lee |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
030506 rehabilitation
medicine.medical_specialty Movement Psychological intervention Motor Activity 03 medical and health sciences 0302 clinical medicine Developmental Neuroscience Medicine Humans Motor activity Physical Therapy Modalities Change score Palsy Cross-Over Studies business.industry Neonatal Brachial Plexus Palsy Infant Crossover study Constraint-induced movement therapy Treatment Outcome Child Preschool Pediatrics Perinatology and Child Health Secondary Outcome Measure Physical therapy Female Neurology (clinical) 0305 other medical science business Brachial plexus 030217 neurology & neurosurgery |
| Zdroj: | Developmental medicine and child neurologyReferences. 63(5) |
| ISSN: | 1469-8749 |
| Popis: | AIM To determine if constraint-induced movement therapy (CIMT) is more effective than standard care in improving upper-limb activity outcomes in children with neonatal brachial plexus palsy (NBPP). METHOD Twenty-one children with NBPP (mean age 25mo, SD=10.3, range=17-48mo; 11 males, 10 females) were enrolled in a crossover trial and randomly allocated to first receive CIMT or standard care, each for 8 weeks. The intervention arm consisted of 3 weeks of casting the unaffected limb followed by 5 weeks of transference activities. The Assisting Hand Assessment (AHA) was used to measure bimanual activity performance at baseline, 8 weeks, and 16 weeks, scored by blinded raters. The Pediatric Motor Activity Log-Revised (PMAL-R) was used as a caregiver-reported secondary outcome measure. RESULTS After concealed random allocation (n=21), there were no significant differences on demographics or baseline measures. CIMT was superior compared to control in terms of bimanual activity performance with a mean difference in AHA change score of 4.8 (SD=10.5, p=0.04, Cohen's δ=0.46). There were no significant differences between treatment conditions on the PMAL-R. INTERPRETATION CIMT is favored over standard care for bimanual activity performance. Future research should investigate a longer follow-up period, additional comparator interventions, and analyse differences by participant characteristics. WHAT THIS PAPER ADDS Gains in bimanual activity performance were greater after constraint-induced movement therapy (CIMT) compared to no CIMT. Frequency and quality of movement were not significantly different between treatment groups. |
| Databáze: | OpenAIRE |
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