Article

The objective of the study was to investigate the feasibility of modified
constraint-induced (CI) therapy provided in a 2-week day-camp model with and
without intramuscular botulinum toxin type A (BoNT-A) injections for children
with congenital cerebral palsy. Sixteen children with congenital hemiplegia,
Manual Ability Classification System (MACS) level I and II, aged 8-17 years,
participated in a CI therapy day camp; of whom five participants (aged 11-16
years) received intramuscular BoNT-A prior to CI therapy. Assessments were
conducted 4 months and 2 weeks before (baselines 1 and 2), immediately after, and
6 months after the day camp. For the children who received BoNT-A, no statistical
analyses were conducted due to the small size of the sample. In this group,
consistent improvement was only found according to the Melbourne Unilateral Limb
Assessment. The children who received only the CI therapy demonstrated
improvements in the Jebsen-Taylor Hand Function Test (p =. 04) at posttest, but
improvements were not sustained at 6-month follow-up. No significant improvement
was obtained for the Melbourne Assessment or the Assisting Hand Assessment.
Children in both groups improved on specially trained tasks: frisbee golf,
stacking blocks, and in-hand manipulation. Feedback from the participants
suggests that the day-camp model is a feasible intervention following
intramuscular BoNT-A injections. The results suggest that children with
congenital hemiplegia with varying severity of impairment in hand function may
benefit from CI therapy, but not every child demonstrates improvements in hand
function. The characteristics of children who respond the best to CI therapy are
not clear.

Langue : ANGLAIS