OBJECTIVE: To investigate the long-term effects of home-based constraint-induced therapy (hCIT) on motor control underlying functional change in children with unilateral cerebral palsy (CP). DESIGN: A randomized controlled trial. SETTING: Home-based. PARTICIPANTS: Forty-five children with unilateral CP (aged 6 to 12 years) were randomly assigned to receive hCIT (n = 23) or traditional rehabilitation (TR) (n = 22). INTERVENTIONS: Both groups received a 4-week therapist-based intervention at home. The hCIT involved intensive functional training of the more affected upper extremity while 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 (post-treatment), and 3 and 6 months (follow-up). The reach-to-grasp kinematics were reaction time (RT), normalized movement time (nMT), normalized movement unit (nMU), peak velocity (PV), maximum grip aperture (MGA), and percentage of movement where MGA occurs (PMGA). The clinical measures were the Peabody Developmental Motor Scale 2 (PDMS-2), Bruininks-Oseretsky Test of Motor Proficiency (BOTMP), and Functional Independence Measure for children (WeeFIM) RESULTS: The hCIT group showed a shorter RT (p < 0.050) and nMT (p < 0.010), smaller MGA (p = 0.006), and fewer nMU (p = 0.014) in the reach-to-grasp movements at post-treatment and follow-up than the TR group. The hCIT group improved more on the PDMS-2 (p < 0.001) and the WeeFIM (p < 0.010) in all post-treatment tests and on the BOTMP (p < 0.010) at follow-up than the TR group. CONCLUSIONS: The hCIT induced better spatial and temporal efficiency (smoother movement, more efficient grasping, and better movement preplanning and execution) for functional improvement up to 6 months after treatment than the TR.

Full text (sometimes free) may be available at these link(s):      help

• DOI
• PubMed
• PDF locator
• publisher