Monik Castillo Dionisio, MS, OTR/L, BCP, CPAM, is Occupational Therapist, California Children's Services, Anaheim, and Post-Professional Doctoral Student, Department of Occupational and Recreational Therapies, University of Utah, Salt Lake City;
Alexandra L. Terrill, PhD, is Clinical Psychologist and Associate Professor, Department of Occupational and Recreational Therapies, University of Utah, Salt Lake City.
Am J Occup Ther. 2022 Mar 1;76(2). doi: 10.5014/ajot.2022.047894.
Although research shows that older children with hemiplegic cerebral palsy (CP) benefit from constraint-induced movement therapy (CIMT), the efficacy of CIMT among the infant population is unknown.
To explore the existing evidence on CIMT for infants age 24 mo and younger with CP or at risk for CP.
PubMed, CINAHL, Cochrane, and ProQuest were searched. Study Selection and Data Collection: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and American Occupational Therapy Association guidelines were used for abstracting data and assessing data quality. Two frameworks guided this scoping review. Studies met the following criteria: infants with hemiplegic CP, published in English between 2000 and 2020, peer reviewed, and addressed changes in upper limb function of the hemiplegic upper limb.
Eight articles met the inclusion criteria: 2 randomized controlled trials, 1 retrospective cohort design, 1 pretest-posttest study, 2 single-subject studies, and 2 case studies. In this scoping review, we examined CIMT protocols for an overview of dosage, constraint, administration, parent training and education, and objective outcome measures.
Existing literature supports CIMT protocols for infants with CP. However, much variability exists in protocol design and appropriate outcome measures among studies. Higher level research is needed to support the efficacy of CIMT among infants with CP. What This Article Adds: This scoping review summarizes the existing literature on CIMT for infants with hemiplegic CP. This information can help guide therapists to implement CIMT protocols in the clinical setting and to identify additional research to establish practice standards.
虽然研究表明,偏瘫脑瘫(CP)较大的儿童从强制性运动疗法(CIMT)中受益,但婴儿人群中 CIMT 的疗效尚不清楚。
探讨针对年龄在 24 个月及以下的 CP 或有 CP 风险的婴儿的 CIMT 现有证据。
在 PubMed、CINAHL、Cochrane 和 ProQuest 进行了搜索。研究选择和数据收集:使用了系统评价和荟萃分析的首选报告项目(PRISMA)和美国职业治疗协会指南来提取数据并评估数据质量。本范围综述采用了两个框架。研究符合以下标准:偏瘫 CP 的婴儿,发表于 2000 年至 2020 年期间的英文文献,同行评审,并解决了偏瘫上肢功能的变化。
8 篇文章符合纳入标准:2 项随机对照试验、1 项回顾性队列设计、1 项测试后研究、2 项单案例研究和 2 项病例研究。在本次范围综述中,我们检查了 CIMT 方案,以概述剂量、约束、管理、家长培训和教育以及客观结果测量。
现有文献支持针对 CP 婴儿的 CIMT 方案。然而,研究之间在方案设计和适当的结果测量方面存在很大的差异。需要进行更高水平的研究来支持 CIMT 在 CP 婴儿中的疗效。本文增加的内容:本范围综述总结了针对偏瘫 CP 婴儿的 CIMT 现有文献。这些信息可以帮助治疗师在临床环境中实施 CIMT 方案,并确定额外的研究以建立实践标准。