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'Remind-to-move' treatment versus constraint-induced movement therapy for children with hemiplegic cerebral palsy: a randomized controlled trial [with consumer summary]
Dong VA, Fong KNK, Chen Y-F, Tseng SSW, Wong LMS
Developmental Medicine and Child Neurology 2017 Feb;59(2):160-167
clinical trial
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

AIM: To evaluate 'remind-to-move' (RTM) treatment by comparing it with constraint-induced movement therapy (CIMT) and conventional rehabilitation of the upper extremity in children with hemiplegic cerebral palsy (CP). METHOD: Seventy-three children (44 males, 29 females; mean age 11 y 8 mo, standard deviation (SD) 3 y 1 mo) -- with 20, 38, and 15 in Manual Ability Classification System levels I, II, and III respectively -- were recruited from three special schools and randomly selected for an RTM (n = 25) or CIMT (n = 24) programme (for 75h over 3 wks) or for conventional rehabilitation (n = 24). The Jebsen-Taylor Hand Function Test, the Bruininks-Oseretsky Test of Motor Proficiency (Subtest 3), the Caregiver Functional Use Survey, and arm movement duration captured by accelerometers were used at the baseline, post-test, and 1-month and 3-month follow-ups. RESULTS: Both the RTM and CIMT treatments achieved significant gains in manual capacities and spontaneous hand use immediately after the intervention compared with conventional rehabilitation, but there were no significant differences between the two interventions. INTERPRETATION: The RTM treatment demonstrated similar therapeutic effects with CIMT in manual dexterity and functional hand use, but both interventions were superior to conventional rehabilitation. RTM is recommended as an alternative treatment for the hemiplegic upper extremity in children with CP.

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