Effect of therapist-based constraint-induced therapy at home on motor control, motor performance and daily function in children with cerebral palsy: a randomized controlled study

被引:31
作者
Chen, Chia-ling [1 ,2 ]
Kang, Lin-ju [2 ,3 ]
Hong, Wei-Hsien [4 ]
Chen, Fei-Chuan [5 ]
Chen, Hsieh-Ching [6 ]
Wu, Ching-yi [7 ,8 ]
机构
[1] Chang Gung Mem Hosp, Tao Yuan, Taiwan
[2] Chang Gung Univ, Coll Med, Grad Inst Early Intervent, Tao Yuan 333, Taiwan
[3] Shu Zen Coll Med & Management, Dept Phys Therapy, Kaohsiung, Taiwan
[4] China Med Univ, Dept Sports Med, Taichung, Taiwan
[5] Buddhist Tzu Chi Gen Hosp, New Taipei City, Taiwan
[6] Natl Taipei Univ Technol, Dept Ind Engn & Management, Taipei, Taiwan
[7] Chang Gung Univ, Coll Med, Grad Inst Behav Sci, Tao Yuan 333, Taiwan
[8] Chang Gung Univ, Coll Med, Dept Occupat Therapy, Tao Yuan 333, Taiwan
关键词
Constraint-induced therapy; cerebral palsy; motor performance; daily function; randomized controlled trial; INDUCED MOVEMENT THERAPY; UPPER-LIMB; OUTCOMES; STROKE; TRIAL;
D O I
10.1177/0269215512455652
中图分类号
R49 [康复医学];
学科分类号
100215 ;
摘要
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.
引用
收藏
页码:236 / 245
页数:10
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