Centre de Réadaptation Marie Enfant, CHU Sainte Justine, Montréal, Québec, Canada.
J Rehabil Med. 2012 Mar;44(3):268-71. doi: 10.2340/16501977-0920.
To evaluate the impact of forced use therapy on posture in children with hemiplegic cerebral palsy.
Single group pre- and post-training assessments.
Eight children (mean age 10.5 years (standard deviation 1.26 years)) with hemiplegic cerebral palsy Levels I and II on the gross motor function classification scale.
All participants underwent 12 days (6 h/day) of forced use therapy. Postural asymmetry as well as the centre of pressure range and peak velocity during quiet standing were evaluated before and after the therapy. Upper limb functional level was also assessed using the Bruininks Oseretsky test of Motor Proficiency and the Assisting Hand Assessment.
Before forced use therapy, postural asymmetry tended to decrease when the participants wore the upper limb constraint. After forced use therapy, upper limb functional scores improved significantly, and postural asymmetry tended to decrease, compared with the pre-therapy values. Postural improvement was correlated with postural asymmetry before forced use therapy. No significant differences were observed on the centre of pressure displacement parameters during the quiet standing tests in all conditions.
This pilot study showed that forced use therapy may be an efficient way to improve postural asymmetry in children with hemiplegic cerebral palsy.
评估强制性使用疗法对偏瘫型脑瘫患儿姿势的影响。
单组训练前后评估。
8 名偏瘫型脑瘫患儿（平均年龄 10.5 岁[标准差 1.26 岁]），粗大运动功能分级量表 I 级和 II 级。
所有参与者均接受 12 天（每天 6 小时）的强制性使用疗法。在治疗前后评估静立位时的姿势不对称以及中心压力范围和峰值速度。使用布鲁因克斯运动机能测试和辅助手评估来评估上肢功能水平。
在强制性使用上肢限制装置时，患儿的姿势不对称性趋于减少。与治疗前相比，经过强制性使用疗法后，上肢功能评分显著提高，姿势不对称性趋于减少。姿势改善与强制性使用治疗前的姿势不对称性相关。在所有条件下，静立位测试的中心压力位移参数均无显著差异。
这项初步研究表明，强制性使用疗法可能是改善偏瘫型脑瘫患儿姿势不对称的有效方法。
