scholarly journals Application of Low-Intensity Modified Constraint-Induced Movement Therapy to Improve the Affected Upper Limb Functionality in Infantile Hemiplegia with Moderate Manual Ability: Case Series

Children ◽  
2020 ◽  
Vol 7 (9) ◽  
pp. 127
Author(s):  
Rocío Palomo-Carrión ◽  
Rita-Pilar Romero-Galisteo ◽  
Elena Pinero-Pinto ◽  
Purificación López-Muñoz ◽  
Helena Romay-Barrero ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Upper Limb ◽  
Case Series ◽  
Movement Therapy ◽  
Low Intensity ◽  
Constraint Induced Movement Therapy ◽  
Case Series Study ◽  
Quality Of Movement ◽  
Pre Treatment

Objective: To assess the functionality of the affected upper limb in children diagnosed with hemiplegia aged between 4 and 8 years after applying low-intensity modified Constraint-Induced Movement Therapy (mCIMT). Methods: Prospective case series study. A mCIMT protocol was applied for five weeks, with two hours of containment per day. The study variables were quality of movement of the upper limb, spontaneous use, participation of the affected upper limb in activities of daily living, dynamic joint position, grasp–release action, grasp strength, supination and extension elbow movements. Four measurements were performed, using the quality of upper extremity test (QUEST) scale, the Shriners Hospital for Children Upper Extremity Evaluation (SHUEE) Evaluation, a hand dynamometer and a goniometer. Results: The sample was composed of eight children with moderate manual ability. Statistically significant differences were detected in all the studied variables (p < 0.05) between the pre-treatment and post–treatment results (Week 0–Week 5), except for upper limb dressing, putting on splints and buttoning up. In the first week, the changes were statistically significant, except for protective extension, grasp strength, grasp–release and all functional variables (level of functionality and participation of the patient’s upper limbs) in the SHUEE Evaluation (p > 0.05). The greatest increase occurred in spontaneous use from Assessment 1 to Assessment 4 (p = 0.01), reaching 88.87% active participation in bimanual tasks. The quality of movement of the upper limb exhibited a significant value due to the increase in dissociated movements and grasp (p = 0.01). Conclusion: A low dose (50 h) of mCIMT increased the functionality of children diagnosed with congenital hemiplegia between 4 and 8 years of age with moderate manual ability.

scholarly journals Application of Low-Intensity Modified Constraint-Induced Movement Therapy to Improve the Affecter Upper Limb Functionality in Infantile Hemiplegia with Moderate Manual Ability. Case Series

2020 ◽  
Author(s):  
Rocío Palomo-Carrión ◽  
Rita-Pilar Romero-Galisteo ◽  
Elena Piñero-Pinto ◽  
Purificación López-Muñoz ◽  
Helena Romay-Barrero ◽  
...  
Keyword(s):  
Upper Limb ◽  
Case Series ◽  
Movement Therapy ◽  
Low Intensity ◽  
Constraint Induced Movement Therapy ◽  
Case Series Study ◽  
Quality Of Movement ◽  
Prospective Case Series ◽  
Quest Scale

Objective: To assess the functionality of the affected upper limb in children diagnosed with hemiplegia aged between 4 and 8 years after applying low-intensity modified constraint-induced movement therapy(mCIMT). Methods: Prospective case series study. A mCIMT protocol was applied for five weeks, with two hours of containment per day. The study variables were: quality of movement of the upper limb, spontaneous use, participation of the affected upper limb in activities of daily living, dynamic joint position, grasp-release action, grasp strength, supination and extension elbow movements. Four measurements were performed, using the QUEST scale, the SHUEE Evaluation, a hand dynamometer and a goniometer. Results: The sample was composed of 8 children with moderate manual ability. Statistically significant differences were detected in all the studied variables (p&amp;lt;0.05). The greatest increase occurred in spontaneous use from assessment 1-4 (p = 0.01), reaching 88.87% active participation in bimanual tasks. The quality of movement of the upper limb obtained a significant value due to the increase in dissociated movements and grasp (p = 0.01). Conclusion: A low dose (50 hours) of mCIMT increased the functionality of children diagnosed with congenital hemiplegia between 4 and 8 years of age with moderate manual ability.

scholarly journals Unimanual Intensive Therapy with or without Unaffected Hand Containment in Children with Hemiplegia. A Randomized Controlled Pilot Study

2020 ◽  
Vol 9 (9) ◽  
pp. 2992
Author(s):  
Rocío Palomo-Carrión ◽  
Elena Pinero-Pinto ◽  
Sara Ando-LaFuente ◽  
Asunción Ferri-Morales ◽  
Elisabeth Bravo-Esteban ◽  
...  
Keyword(s):  
Pilot Study ◽  
Upper Extremity ◽  
Upper Limb ◽  
Intensive Therapy ◽  
Randomized Controlled ◽  
Upper Limb Function ◽  
Constraint Induced Movement Therapy ◽  
Quality Of Movement ◽  
Quest Scale

Children with hemiplegia have lower spontaneous use and quality of movement in the affected upper limb. The modified constraint-induced movement therapy (mCIMT) is applied to improve the affected upper limb function. The objective of this study was to study the efficacy of unaffected hand containment to obtain changes in the function of the affected upper limb after applying two unimanual therapies. A randomized controlled pilot study was performed with 16 children diagnosed with congenital infantile hemiplegia, with eight children randomized in each group (average age: 5.54 years; SD: 1.55). mCIMT and unimanual therapy without containment (UTWC) were applied, with a total of 50 h distributed in five weeks (two h/per day). Two assessments were performed (pre- and post-treatment) to evaluate the affected upper limb spontaneous use, measured with the Shiners Hospital Upper Extremity Evaluation (SHUEE), and the quality of movement, measured with the Quality of Upper Extremity Skills Test (QUEST scale). The progression of the variables was different in both groups. The results are expressed in the median of the improvement percent and interquartile range (IQR). The spontaneous use analysis showed an improvement percent of 31.65 (IQR: 2.33, 110.42) in the mCIMT group with respect to 0.00 (IQR: 0.00, 0.00) in the UTWC group. The quality of movement increased in the mCIMT and UTWC groups, 24.21 (IQR: 13.44, 50.39), 1.34 (IQR: 0.00, 4.75), respectively and the greatest increase was obtained in the grasp variable for both groups. The use of unaffected hand containment in mCIMT would produce improvements in the affected upper limb functionality in children with hemiplegia (4–8 years old) compared to the same protocol without containment (UTWC).

scholarly journals Constraint-Induced Movement Therapy for Individuals After Cerebral Hemispherectomy: A Case Series

2009 ◽  
Vol 89 (4) ◽  
pp. 361-369 ◽  
Author(s):  
Stella de Bode ◽  
Stacy L Fritz ◽  
Kristi Weir-Haynes ◽  
Gary W Mathern
Keyword(s):  
Brain Imaging ◽  
Upper Extremity ◽  
Case Series ◽  
Movement Therapy ◽  
Constraint Induced Movement Therapy ◽  
Before And After ◽  
Block Test ◽  
Cortical Representations ◽  
The Brain ◽  
Qualitative Changes

Background and PurposeThis case report describes the feasibility and efficacy of the use of constraint-induced movement therapy (CIMT) in 4 individuals (aged 12–22 years) who underwent cerebral hemispherectomy (age at time of surgery=4–10 years). The aims of this case series were: (1) to evaluate the feasibility of this therapeutic approach involving a shortened version of CIMT, (2) to examine improvements that occurred within the upper extremity of the hemiparetic side, (3) to investigate the feasibility of conducting brain imaging in individuals with depressed mental ages, and (4) to examine changes in the sensorimotor cortex following intervention.Case DescriptionThe patients received a shortened version of CIMT for 3 hours each day for a period of 10 days. In addition, a standard resting splint was used for the unimpaired hand for an 11-day period. Each patient was encouraged to wear the splint for 90% of his or her waking hours. The following outcome measures were used: the Actual Amount of Use Test (AAUT), the Box and Block Test (BBT), and the upper-extremity grasping and motor portions of the Fugl-Meyer Assessment of Motor Recovery (FM).OutcomesImmediately after therapy, improvements were found in AAUT and BBT scores, but no improvements were found in FM scores. Three patients underwent brain imaging before and after therapy and showed qualitative changes consistent with reorganization of sensorimotor cortical representations of both paretic and nonparetic hands in one isolated hemisphere.DiscussionThe findings suggest that CIMT may be a feasible method of rehabilitation in individuals with chronic hemiparesis, possibly leading to neuroplastic therapy–related changes in the brain.

scholarly journals Análise qualitativa do efeito da terapia por contensão induzida em crianças com paralisia cerebral

2019 ◽  
Vol 30 (2) ◽  
pp. 132-139
Author(s):  
Liz Araújo Rohr ◽  
Camila Araújo Santana ◽  
Erika Shirley Moreira da Silva ◽  
Carolina Daniel de Lima Alvarez ◽  
Gabriela Lopes dos Santos Maia ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Scale Score ◽  
Upper Limb ◽  
Movement Therapy ◽  
Limb Movement ◽  
Functional Activities ◽  
Constraint Induced Movement Therapy ◽  
Quest Scale ◽  
Training Protocol

This study describes the results of four children with hemiparetic cerebral palsy, age between four and eleven years (6.50± 3.32) who had performed a Constraint-induced Movement Therapy (CIMT) protocol. The purpose was to analyze qualitatively the effects of the CIMT protocol on the use of the affected upper limb. The protocol was performed for three weeks, with restriction of the nonaffected upper limb and functional activities were performed with the transfer of gains during treatment to the real environment. A qualitativeanalysis of the upper limb movement was performed through the Quality of Upper Skills Test (QUEST) scale and the assessment of distal adjustments. Improvements on the QUEST scale score and on the distal adjustments were observed in all four participants after the training protocol. The constraint-induced movement therapy may be an effective intervention aiming to improve the quality of the upper limb movement in children with hemiparetic cerebral palsy.

scholarly journals A randomized controlled trial to compare two methods of constraint-induced movement therapy to improve functional ability in the affected upper limb in pre-school children with hemiplegic cerebral palsy: CATCH TRIAL

2018 ◽  
Vol 32 (7) ◽  
pp. 909-918 ◽  
Author(s):  
Pauline M Christmas ◽  
Catherine Sackley ◽  
Max G Feltham ◽  
Carole Cummins
Keyword(s):  
Randomized Controlled Trial ◽  
Cerebral Palsy ◽  
Upper Limb ◽  
Controlled Trial ◽  
Movement Therapy ◽  
Randomized Controlled ◽  
Upper Limb Function ◽  
Constraint Induced Movement Therapy ◽  
Hemiplegic Cerebral Palsy

Objective: To determine the feasibility and short-term efficacy of caregiver-directed constraint-induced movement therapy to improve upper limb function in young children with hemiplegic cerebral palsy. Design: Randomized controlled trial with masked assessment. Setting: Community paediatric therapy services. Subjects: Pre-school children with hemiplegic cerebral palsy. Interventions: Caregiver-directed constraint-induced movement therapy administered using either 24-hour short-arm restraint device (prolonged) or intermittent holding restraint during therapy (manual). Main measures: Primary measures include Assisting Hand Assessment (AHA) at 10 weeks. Secondary measures include adverse events, Quality of Upper Extremity Skills Test and Pediatric Quality of Life Inventory. Feasibility measures include recruitment, retention, data completeness and adherence. Results: About 62/81 (72%) of eligible patients in 16 centres were randomized (prolonged restraint n = 30; manual restraint n = 32) with 97% retention at 10 weeks. The mean change at 10 weeks on the AHA logit-based 0–100 unit was 9.0 (95% confidence interval (CI): 5.7, 12.4; P < 0.001) for prolonged restraint and 5.3 (95% CI: 1.3, 9.4; P = 0.01) for manual restraint with a mean group difference of 3.7 (95% CI: −1.5, 8.8; P = 0.156) (AHA smallest detectable difference = 5 units). No serious related adverse events were reported. There were no differences in secondary outcomes. More daily therapy was delivered with prolonged restraint (60 vs 30 minutes; P < 0.001). AHA data were complete at baseline and 10 weeks. Conclusion: Caregiver-directed constraint-induced movement therapy is feasible and associated with improvement in upper limb function at 10 weeks. More therapy was delivered with prolonged than with manual restraint, warranting further testing of this intervention in a longer term trial.

Effects of sling and voluntary constraint during constraint-induced movement therapy for the arm after stroke: a randomized, prospective, single-centre, blinded observer rated study

2012 ◽  
Vol 26 (11) ◽  
pp. 990-998 ◽  
Author(s):  
Maciej Krawczyk ◽  
Marta Sidaway ◽  
Anna Radwańska ◽  
Joanna Zaborska ◽  
Renata Ujma ◽  
...  
Keyword(s):  
Movement Therapy ◽  
Motor Deficits ◽  
Stroke Patients ◽  
Voluntary Activity ◽  
Massed Practice ◽  
Constraint Induced Movement Therapy ◽  
Significant Difference ◽  
Quality Of Movement ◽  
Rivermead Motor Assessment

Objective: To determine whether a combination of constraint-induced movement therapy and physiotherapy in stroke patients using different constraint regimens (sling versus voluntary constraint) changes or reduces motor deficits, the amount of functional use of the arm and whether the effects of treatment continue after 12 months. Design: Forty-seven stroke patients were stratified and randomly divided into intensive physiotherapy programmes focused on regaining arm functions. Setting: Neurorehabilitation Unit of IInd Department of Neurology at Institute of Psychiatry and Neurology in Warsaw. Subject: Patients were randomly allocated to: the sling-constraint group ( n = 24) or to the voluntary-constraint group ( n = 23). Interventions: Massed practice with the paretic arm (5 hours/day for 15 consecutive working days). Sling-constraint group had their arm immobilized in a hemi-sling during therapy. In addition, individual, 1-hour physiotherapy sessions were conducted in both groups. Main measures: Rivermead Motor Assessment (RMA) Arm scale, (0–15), Motor Activity Log – Quality of Movement (MAL-QOM) (0–5 for 30 daily tasks). Results: There was no significant difference between groups after therapy (MAL-QOM mean change for sling group 0.78, SD = 0.46 and for voluntary-constraint group 0.84, SD = 0.48; P = 0.687). All treated patients retained mean gains in real-world arm use (MAL-QOM) mean scores after 12 months follow-up compared with posttreatment values but there was no significant difference between groups (comparison of estimated mean change of MAL-QOM stated 0.23. 95% confidence interval = −0.04–0.50). Conclusion: Voluntary activity constraint in the intact arm is equivalent to sling, standard constraint during massed practice of paretic arm.

scholarly journals Imagética motora e terapia por contensão induzida modificada na disfunção do membro superior pós-AVE – Revisão Sistemática

2021 ◽  
pp. 133-166
Author(s):  
Thamiris Barbosa da Silva ◽  
Rodrigo Freitas ◽  
Luiz Carlos Soares de Oliveira
Keyword(s):  
Upper Extremity ◽  
Upper Limb ◽  
Movement Therapy ◽  
Mental Practice ◽  
Constraint Induced Movement Therapy

Segundo a Organização Mundial de Saúde (OMS) o Acidente Vascular Encefálico (AVE) é uma das causas que mais leva a morbidade e mortalidade no mundo. A Terapia por Contensão Induzida (TCI) é uma técnica de reabilitação derivada da neuropsicologia que tem como objetivo recuperar a função do membro superior acometido por uma lesão. Prática mental (PM), também conhecida como Imagética Motora (IM), consiste no método de treinamento em que a reprodução interna de um determinado evento é repetida extensivamente com a intenção de aprender uma nova habilidade ou melhorar o desempenho de uma tarefa já conhecida. O objetivo do presente estudo foi comparar as técnicas de TCIM e IM em relação a seus benefícios como ferramenta de reabilitação na melhora do desempenho da disfunção do membro superior decorrentes de AVE. Trata-se de uma revisão sistemática da literatura realizada no período de março a abril 2020. Para a busca utilizaram-se as bases de dados PEDro, Lilacs, Medline e Pubmed de artigos no idioma português, inglês e espanhol, publicados de 2015 a 2020, com as palavras-chaves Constraint-induced movement therapy, Stroke, Upper Limb/ Upper Extremity, Imagery Motor e Mental Practice e suas respectivas correspondências em português. Na busca eletrônica pelos bancos de dados Lilacs, Pedro, Medline e Pubmed, cruzando as palavras descritas no método, foram encontrados 526 artigos, destes foram selecionados 217 artigos para leitura na íntegra. Os resultados desta revisão sistemática indicam que ambas as técnicas foram igualmente capazes de proporcionar benefícios na melhora do desempenho da disfunção do membro superior decorrentes do AVE. Embora, os melhores resultados foram observados quando associadas a outras técnicas ou quando combinadas.

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