Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan.
Clin Rehabil. 2013 Mar;27(3):236-45. doi: 10.1177/0269215512455652. Epub 2012 Sep 5.
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.
A single-blinded, randomized controlled trial.
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).
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.
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.
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.
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.
确定基于治疗师的家庭强制性诱导治疗对脑瘫儿童运动表现、日常功能和伸手控制的影响。
单盲、随机对照试验。
47 名年龄在 6-12 岁的单侧脑瘫儿童（23 名男孩；24 名女孩）被随机分为强制性诱导治疗组（n = 24）或传统康复组（n = 23）。
强制性诱导治疗包括对较严重的手臂进行强化功能性训练，同时限制较轻的手臂活动。传统康复包括对单侧和双侧手臂进行功能性训练。两组患儿均在家中接受个体化的基于治疗师的干预，每天 3.5-4 小时，每周 2 天，持续 4 周。
运动表现和日常功能通过 Peabody 发育运动量表第二版和小儿运动活动日志进行评估。伸手控制通过反应时间、运动时间、运动单元和峰值速度的运动学来评估。
与传统康复相比，强制性诱导治疗在运动表现、日常功能和伸手控制的某些方面具有更大的效果。接受强制性诱导治疗的儿童在 Peabody 发育运动量表第二版的抓握方面得分更高（预测试均数 ± 标准差，39.9 ± 3.1；后测试，44.1 ± 2.8；P < 0.001），小儿运动活动日志得分更高（预测试，1.8 ± 0.3；后测试，2.5 ± 0.3；P < 0.001），反应时间更短，正常化运动时间更短（P < 0.001），伸手运动的峰值速度更高（P = 0.004）。
与传统康复相比，家庭强制性诱导治疗可改善脑瘫儿童的抓握表现、日常功能以及伸手运动的时间和时空控制。
