scholarly journals Randomized controlled trial combining constraint-induced movement therapy and action-observation training in unilateral cerebral palsy: clinical effects and influencing factors of treatment response

2020 ◽  
Vol 13 ◽  
pp. 175628641989806 ◽  
Author(s):  
Cristina Simon-Martinez ◽  
Lisa Mailleux ◽  
Jasmine Hoskens ◽  
Els Ortibus ◽  
Ellen Jaspers ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Treatment Response ◽  
Influencing Factors ◽  
Action Observation ◽  
Sensory Function ◽  
Constraint Induced Movement Therapy ◽  
Bimanual Performance ◽  
Unilateral Cerebral Palsy ◽  
Observation Training

Introduction: Constraint-induced movement therapy (CIMT) improves upper limb (UL) motor execution in unilateral cerebral palsy (uCP). As these children also show motor planning deficits, action-observation training (AOT) might be of additional value. Here, we investigated the combined effect of AOT to CIMT and identified factors influencing treatment response. Methods: A total of 44 children with uCP (mean 9 years 6 months, SD 1 year 10 months) participated in a 9-day camp wearing a splint for 6 h/day and were allocated to the CIMT + AOT ( n = 22) and the CIMT + placebo group ( n = 22). The CIMT + AOT group received 15 h of AOT (i.e. video-observation) and executed the observed tasks, whilst the CIMT + AOT group watched videos free of biological motion and executed the same tasks. The primary outcome measure was bimanual performance. Secondary outcomes included measures of body function and activity level assessed before (T1), after the intervention (T2), and at 6 months follow-up (T3). Influencing factors included behavioural and neurological characteristics. Results: Although no between-groups differences were found ( p > 0.05; η2 = 0–16), the addition of AOT led to higher gains in children with initially poorer bimanual performance ( p = 0.02; η2 = 0.14). Both groups improved in all outcome measures after the intervention and retained the gains at follow up ( p < 0.01; η2 = 0.02–0.71). Poor sensory function resulted in larger improvements in the total group ( p = 0.03; η2 = 0.25) and high amounts of mirror movements tended to result in a better response to the additional AOT training ( p = 0.06; η2 = 0.18). Improvements were similar irrespective of the type of brain lesion or corticospinal tract wiring pattern. Conclusions: Adding AOT to CIMT, resulted in a better outcome for children with poor motor function and high amounts of mirror movements. CIMT with or without AOT seems to be more beneficial for children with poor sensory function. Trial registration: Registered at ClinicalTrials.gov on 22nd August 2017 (ClinicalTrials.gov identifier: NCT03256357).

scholarly journals Randomized controlled trial combining constraint-induced movement therapy and action-observation training in unilateral cerebral palsy: clinical effects and influencing factors of treatment response

2019 ◽  
Author(s):  
Cristina Simon-Martinez ◽  
Lisa Mailleux ◽  
Jasmine Hoskens ◽  
Els Ortibus ◽  
Ellen Jaspers ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Treatment Response ◽  
Influencing Factors ◽  
Action Observation ◽  
Sensory Function ◽  
Constraint Induced Movement Therapy ◽  
Bimanual Performance ◽  
Unilateral Cerebral Palsy ◽  
Observation Training

AbstractIntroductionConstraint-induced movement therapy (CIMT) improves upper limb (UL) motor execution in unilateral cerebral palsy (uCP). As these children also show motor planning deficits, action-observation training (AOT) might be of additional value. Here, we investigated the combined effect of AOT to CIMT and identified factors influencing treatment response.MethodsForty-four children with uCP (mean 9y6m, SD 1y10m) participated in a 9-day camp wearing a splint for 6 hours/day and were allocated to the CIMT+AOT (n=22) and the CIMT+placebo group (n=22). The CIMT+AOT group received 15 hours of AOT (i.e. video-observation) and executed the observed tasks, whilst the CIMT+AOT group watched videos free of biological motion and executed the same tasks. The primary outcome measure was bimanual performance. Secondary outcomes included measures at body function and activity level assessed before (T1), after (T2) the intervention, and at 6 months follow-up (T3). Influencing factors included behavioural and neurological characteristics.ResultsAlthough no between-groups differences were found (p>0.05), the addition of AOT led to higher gains in children with initially poorer bimanual performance (p=0.02). Both groups improved in all outcome measures after the intervention and retained the gains at follow up (p<0.01). Poor sensory function resulted in larger improvements in the total group (p=0.03) and high amount of mirror movements tended to result in better response to the additional AOT training (p=0.06). Improvements were similar irrespective of the type of brain lesion or corticospinal tract wiring pattern.ConclusionsAdding AOT to CIMT, resulted in better outcome for children with poor motor function and high amount of mirror movements. CIMT with or without AOT seems to be more beneficial for children with poor sensory function.Trial registrationRegistered at ClinicalTrials.gov on 22nd August 2017 (Identifier: NCT03256357).

scholarly journals Effects of combining constraint-induced movement therapy and action-observation training on upper limb kinematics in children with unilateral cerebral palsy: A randomized controlled trial

2019 ◽  
Author(s):  
Cristina Simon-Martinez ◽  
Lisa Mailleux ◽  
Ellen Jaspers ◽  
Els Ortibus ◽  
Kaat Desloovere ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Motor Control ◽  
Upper Limb ◽  
Peak Velocity ◽  
Action Observation ◽  
Movement Patterns ◽  
Movement Duration ◽  
Constraint Induced Movement Therapy ◽  
Unilateral Cerebral Palsy ◽  
Observation Training

AbstractModified constraint-induced movement therapy (mCIMT) improves upper limb (UL) motor execution in unilateral cerebral palsy (uCP). As these children also show motor planning deficits, action-observation training (AOT) might be of additional value. Here, we investigated the combined value of AOT to mCIMT on UL kinematics in children with uCP. Thirty-six children with uCP completed an UL kinematic evaluation after participating in a 9-day mCIMT camp wearing a splint for 6 hours/day. The experimental group (mCIMT+AOT, n=20) received 15 hours of AOT, i.e. video-observation and execution of unimanual tasks. The control group (mCIMT+placebo, n=16) watched biological-motion free videos and executed the same tasks. We examined changes in motor control (movement duration, peak velocity, time-to-peak velocity, and trajectory straightness) and movement patterns (using Statistical Parametric Mapping) during the execution of three unimanual, relevant tasks before the intervention, after and at 6 months follow-up. Adding AOT to mCIMT mainly affected movement duration during reaching, whereas little benefit is seen on UL movement patterns. mCIMT, with or without AOT, improved peak velocity and trajectory straightness, and proximal movement patterns. These results highlight the importance of including kinematics in an UL evaluation to capture changes in motor control and movement patterns of the proximal joints.

Improved Hand Function in Children With Cerebral Palsy With Repeat Doses of Augmented Pediatric Constraint-Induced Movement Therapy

2021 ◽  
Vol 75 (Supplement_2) ◽  
pp. 7512515296p1-7512515296p1
Author(s):  
Heather Roberts ◽  
Angela Shierk ◽  
Arianne Joy V. Alfonso ◽  
Mauricio R. Delgado ◽  
Paul Yeatts
Keyword(s):  
Cerebral Palsy ◽  
Hand Function ◽  
Movement Therapy ◽  
Upward Trend ◽  
Constraint Induced Movement Therapy ◽  
Bimanual Performance ◽  
Children With Cerebral Palsy ◽  
Unilateral Cerebral Palsy ◽  
Primary Author ◽  
Over Time

Abstract Date Presented 04/13/21 Children with unilateral cerebral palsy participating in repeat doses of pediatric constraint-induced movement therapy camp augmented with the Hocoma Armeo®Spring demonstrated significant improvements in hand function and bimanual performance for both doses and showed a generalized upward trend in hand function over time. Primary Author and Speaker: Heather Roberts Additional Authors and Speakers: Sara P. Johnston, David Plutschack

Effect of action observation therapy on motor function in children with cerebral palsy: a systematic review of randomized controlled trials with meta-analysis

2020 ◽  
pp. 026921552095434
Author(s):  
Naglaa Abdelhaleem ◽  
Samar Taher ◽  
Menna Mahmoud ◽  
Ahmad Hendawy ◽  
Maged Hamed ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Methodological Quality ◽  
Randomised Controlled Trials ◽  
Action Observation ◽  
Meta Analysis ◽  
Post Treatment ◽  
Controlled Trials ◽  
Children With Cerebral Palsy ◽  
Randomised Controlled

Objective: To evaluate the evidence of using Action Observation Therapy in the rehabilitation of children with Cerebral Palsy. Study design: Systematic review with meta-analysis of Randomised Controlled Trials. Methods: For the purpose of identifying relevant studies, six databases were searched from inception until July 2020. The methodological quality was assessed by Physiotherapy Evidence Database scale. The outcomes were classified within the framework of the International Classification of Functioning. A pooled meta-analysis was performed on studies that demonstrated homogeneity. Results: Twelve randomised controlled trials with 307 participants were included with six of them were included in the meta-analysis. Non-significant difference between the groups was demonstrated by meta-analysis. Results of capacity assessed in post treatment and follow up evaluation were (0.06, –0.22 to 0.34, 95% (CI); P = 0.69 and (–0.35, –0.96 to 0.27, 95% (CI); P = 0.27); respectively. Actual performance in post-treatment and follow up were (0.10, –0.22 to 0.48, 95% (CI); P = 0.62) and (0.01, –0.40 to 0.41, 95% (CI); P = 0.97); respectively. Perceived performance evaluated using (ABILHAND-KIDS) were (0.30, –0.28 to 0.89, 95% (CI); P = 0.31) and (0.15, –0.43 to 0.73, 95% (CI); P = 0.61) for post treatment and follow up; respectively. Overall effect on activity domain was (0.08, –0.11 to 0.28, 95% (CI); P = 0.86) immediately and (0.04, –0.33 to 0.26, 95% (CI); P = 0.49) at follow-up; respectively. Conclusion: No evidence of benefit had been found to draw a firm conclusion regarding the effectiveness of action observation therapy in the rehabilitation of children with cerebral palsy due to limitations in methodological quality and variations between studies.

scholarly journals Assessment of bimanual performance in 3-D movement analysis: Validation of a new clinical protocol in children with unilateral cerebral palsy

2020 ◽  
Vol 63 (5) ◽  
pp. 408-415 ◽  
Author(s):  
Florence Gaillard ◽  
Marine Cacioppo ◽  
Brice Bouvier ◽  
Guillaume Bouzille ◽  
Christopher J. Newman ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Movement Analysis ◽  
Clinical Protocol ◽  
Bimanual Performance ◽  
Unilateral Cerebral Palsy

scholarly journals Mirror Neuron System Activation in Children With Unilateral Cerebral Palsy During Observation of Actions Performed by a Pathological Model

2019 ◽  
Vol 33 (6) ◽  
pp. 419-431 ◽  
Author(s):  
Antonino Errante ◽  
Giuseppe Di Cesare ◽  
Chiara Pinardi ◽  
Fabrizio Fasano ◽  
Silvia Sghedoni ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Mirror Neuron System ◽  
Action Observation ◽  
Mirror Neuron ◽  
Region Of Interest ◽  
Typically Developing ◽  
Neuron System ◽  
Important Region ◽  
Pathological Model ◽  
Unilateral Cerebral Palsy

Background. Recent evidence suggested that Action Observation Therapy (AOT), based on observation of actions followed by immediate reproduction, could be a useful rehabilitative strategy for promoting functional recovery of children affected by unilateral cerebral palsy (UCP). AOT most likely exploits properties of the parieto-premotor mirror neuron system (MNS). This is more intensely activated when participants observe actions belonging to their own motor repertoire. Objective. The aim of the present study was to investigate the issue of whether MNS of UCP children is better activated by actions performed by a paretic hand rather than a healthy one. Methods. Using functional magnetic resonance imaging, we assessed brain activation in a homogeneous group of 10 right UCP children compared with that of 10 right-handed typically developing (TD) children, during observation of grasping actions performed by a healthy or a paretic hand. Results. The results revealed a significant activation within the MNS in both UCP and TD children, more lateralized to the left hemisphere in the TD group. Most important, region of interest (ROI) analysis on parietal and premotor regions showed that, in UCP, the MNS was more strongly activated by observation of actions performed by the paretic hand, a motor model more similar to the observer’s motor repertoire. Conclusions. This study shows that children affected by spastic UCP exhibit enhanced activation of the MNS during observation of goal-directed actions performed by a pathological model with respect to a healthy one.

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