Article

The aim of the study was to explore individual variations in outcome of hand
function after constraint-induced movement therapy (CIMT) in relation to the
organization of corticomotor projection and brain lesion characteristics in
participants with unilateral cerebral palsy (CP). METHOD: Sixteen participants
(eight males, eight females; mean age 13 y, [SD 2 y] range 10-16 y) with
unilateral CP (nine right-sided; Manual Ability Classification System [MACS]
level I, n=1; level II, n=15) who participated in a 2-week CIMT day camp (63 h)
were included in the study. Various aspects of hand function were measured by the
Jebsen-Taylor Hand Function Test (JTHFT), the Assisting Hand Assessment (AHA),
and the Melbourne Assessment, both before and after the day camp. Transcranial
magnetic stimulation was used to explore the corticomotor organization, and brain
lesion characteristics were described by visual assessment of conventional
structural magnetic resonance images. RESULTS: At a group level, the training was
associated with significant improvements in JTHFT (p=0.003) and AHA (p=0.046),
but not in Melbourne Assessment scores. Improvements were found in all types of
corticomotor projection patterns, i.e. contralateral, mixed, and ipsilateral.
There was no relationship between functional improvement and brain lesion
characteristics. INTERPRETATION: Individuals with CP experience improved motor
outcomes after CIMT, independent of corticomotor projection pattern and lesion
characteristics.
CI - (c) 2013 Mac Keith Press.

Langue : ANGLAIS