Article

OBJECTIVE: To investigate the long-term effects of home-based constraint induced
therapy (CIT) on motor control underlying functional change in children with
unilateral cerebral palsy (CP). DESIGN: Randomized controlled trial. SETTING:
Home based. PARTICIPANTS: Children with unilateral CP (N=45; aged 6-12 y) were
randomly assigned to receive home-based CIT (n=23) or traditional rehabilitation
(TR) (n=22). INTERVENTIONS: Both groups received a 4-week therapist-based
intervention at home. The home-based CIT involved intensive functional training
of the more affected upper extremity during which the less affected one was
restrained. The TR involved functional unimanual and bimanual training. MAIN
OUTCOME MEASURES: All children underwent kinematic and clinical assessments at
baseline, 4 weeks (posttreatment), and 3 and 6 months (follow-up). The
reach-to-grasp kinematics were reaction time (RT), normalized movement time,
normalized movement unit, peak velocity (PV), maximum grip aperture (MGA), and
percentage of movement where MGA occurs. The clinical measures were the Peabody
Developmental Motor Scales, Second Edition (PDMS-2), Bruininks-Oseretsky Test of
Motor Proficiency (BOTMP), and Functional Independence Measure for children
(WeeFIM). RESULTS: The home-based CIT group showed a shorter RT (P<.05) and
normalized movement time (P<.01), smaller MGA (P=.006), and fewer normalized
movement units (P=.014) in the reach-to-grasp movements at posttreatment and
follow-up than the TR group. The home-based CIT group improved more on the PDMS-2
(P<.001) and WeeFIM (P<.01) in all posttreatment tests and on the BOTMP (P<.01)
at follow-up than the TR group. CONCLUSIONS: The home-based CIT induced better
spatial and temporal efficiency (smoother movement, more efficient grasping,
better movement preplanning and execution) for functional improvement up to 6
months after treatment than TR.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS