Article

OBJECTIVE: To determine the effect of therapist-based constraint-induced therapy
at home on motor performance, daily function and reaching control for children
with cerebral palsy. DESIGN: A single-blinded, randomized controlled trial.
SUBJECTS: Forty-seven children (23 boys; 24 girls) with unilateral cerebral
palsy, aged 6-12 years, were randomized to constraint-induced therapy (n = 24) or
traditional rehabilitation (n = 23). INTERVENTIONS:
Constraint-induced therapy
involved intensive functional training of the more affected arm while the less
affected arm was restrained. Traditional rehabilitation involved functional
unilateral and bilateral arm training. Both groups received individualized
therapist-based interventions at home for 3.5-4 hours/day, two days a week for
four weeks. MAIN MEASURES: Motor performance and daily function were measured by
the Peabody Developmental Motor Scale, Second Edition and the Pediatric Motor
Activity Log. Reaching control was assessed by the kinematics of reaction time,
movement time, movement unit and peak velocity. RESULTS: There were larger
effects in favour of constraint-induced therapy on motor performance, daily
function, and some aspects of reaching control compared with traditional
rehabilitation. Children receiving constraint-induced therapy demonstrated higher
scores for Peabody Developmental Motor Scale, Second Edition - Grasping (pretest
mean +/- SD, 39.9 +/- 3.1; posttest, 44.1 +/- 2.8; P < 0.001), Pediatric Motor
Activity Log (pretest, 1.8 +/- 0.3; posttest, 2.5 +/- 0.3; P < 0.001) and shorter
reaction time, normalized movement time (P < 0.001) and higher peak velocity (P =
0.004) of reaching movement. CONCLUSIONS: Constraint-induced therapy induced
better grasping performance, daily function, and temporal and spatiotemporal
control of reaching in children with unilateral cerebral palsy than traditional
rehabilitation.

Langue : ANGLAIS