Brianna M. Goodwin, MS, is Research Engineer, Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN. At the time of the research, she was Graduate Student, Department of Mechanical Engineering, University of Washington, Seattle, and Clinical Research Assistant, Rehabilitation Medicine, Seattle Children's Hospital, Seattle, WA.
Emily K. Sabelhaus, MS, OTR/L, is Occupational Therapist, Rehabilitation Medicine, Seattle Children's Hospital, Seattle, WA, and Pediatric Occupational Therapist, Whatcom Center for Early Learning, Bellingham, WA.
Am J Occup Ther. 2020 Sep/Oct;74(5):7405205100p1-7405205100p9. doi: 10.5014/ajot.2020.040246.
Constraint-induced movement therapy (CIMT) is a common treatment for children with unilateral cerebral palsy (CP). Although clinic-based assessments have demonstrated improvements in arm function after CIMT, whether these changes are translated and sustained outside of a clinic setting remains unclear.
Accelerometers were used to quantify arm movement for children with CP 1 wk before, during, and 4 wk or more after CIMT; measurements were compared with those from typically developing (TD) peers.
Observational.
Tertiary hospital and community.
Seven children with CP (5 boys, 2 girls; average [AVE] age ± standard deviation [SD] = 7.4 ± 1.2 yr) and 7 TD peers (2 boys, 5 girls; AVE age ± SD = 7.0 ± 2.3 yr).
30-hr CIMT protocol.
Use ratio, magnitude ratio, and bilateral magnitude were calculated from the accelerometer data. Clinical measures were administered before and after CIMT, and parent surveys assessed parent and child perceptions of wearing accelerometers.
During CIMT, the frequency and magnitude of paretic arm use among children with CP increased in the clinic and in daily life. After CIMT, although clinical scores showed sustained improvement, the children's accelerometry data reverted to baseline values. Children and parents in both cohorts had positive perceptions of accelerometer use.
The lack of sustained improvement in accelerometry metrics after CIMT suggests that therapy gains did not translate to increased movement outside the clinic. Additional therapy may be needed to help transfer gains outside the clinic.
Accelerometer measurements were effective at monitoring arm movement outside of the clinic during CIMT and suggested that additional interventions may be needed after CIMT to sustain benefits.
限制诱导运动疗法（CIMT）是治疗单侧脑瘫（CP）儿童的常用方法。虽然基于诊所的评估表明 CIMT 后手臂功能有所改善，但这些变化是否在诊所环境之外得到转化和维持尚不清楚。
使用加速度计在 CIMT 之前、期间和之后 4 周或更长时间内，对 CP 儿童的手臂运动进行量化；并将测量结果与正常发育（TD）同龄人的测量结果进行比较。
观察性。
三级医院和社区。
7 名 CP 儿童（5 名男孩，2 名女孩；平均[AVE]年龄±标准差[SD]=7.4±1.2 岁）和 7 名 TD 同龄儿童（2 名男孩，5 名女孩；AVE 年龄±SD=7.0±2.3 岁）。
30 小时 CIMT 方案。
从加速度计数据中计算使用比、幅度比和双侧幅度。在 CIMT 前后进行临床评估，并进行家长调查，以评估家长和孩子对佩戴加速度计的看法。
在 CIMT 期间，CP 儿童的患侧手臂在诊所和日常生活中的使用频率和幅度增加。CIMT 后，尽管临床评分显示持续改善，但儿童的加速度计数据恢复到基线值。两个队列的儿童和家长对加速度计的使用都有积极的看法。
CIMT 后加速度计指标没有持续改善，这表明治疗效果没有转化为诊所外的运动增加。可能需要额外的治疗来帮助将收益转移到诊所外。
加速度计测量在 CIMT 期间在诊所外监测手臂运动是有效的，并表明 CIMT 后可能需要额外的干预措施来维持收益。
