Wu Qianwen, Peng Tingting, Liu Liru, Zeng Peishan, Xu Yunxian, Yang Xubo, Zhao Yiting, Fu Chaoqiong, Huang Shiya, Huang Yuan, Zhou Hongyu, Liu Yun, Tang Hongmei, He Lu, Xu Kaishou
Department of Rehabilitation, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
School of Medicine, South China University of Technology, Guangzhou, China.
Front Behav Neurosci. 2022 Apr 5;16:876567. doi: 10.3389/fnbeh.2022.876567. eCollection 2022.
Constraint-induced movement therapy (CIMT) combined with repetitive transcranial magnetic stimulation (rTMS) have shown great potential in improving function in schoolchildren with unilateral cerebral palsy attributed to perinatal stroke. However, the prospect of application in preschool children with unilateral cerebral palsy (UCP) attributed to various brain disorders remains unclear. In this prospective, assessor-blinded, randomized controlled study, 40 preschool children with UCP (aged 2.5-6 years) were randomized to receive 10 days of CIMT combined with active or sham rTMS. Assessments were performed at baseline, 2 weeks, and 6 months post-intervention to investigate upper limb extremity, social life ability, and perceived changes by parents and motor-evoked potentials. Overall, 35 participants completed the trial. The CIMT plus active stimulation group had greater gains in the affected hand function (range of motion, accuracy, and fluency) than the CIMT plus sham stimulation group ( < 0.05), but there was no significant difference in muscular tone, social life ability, and perceived changes by parents between the two groups ( > 0.05). In addition, there was no significant difference in hand function between children with and without motor-evoked potential ( > 0.05). No participants reported severe adverse events during the study session. In short, the treatment of CIMT combined with rTMS is safe and feasible for preschool children with UCP attributed to various brain disorders. Randomized controlled studies with large samples and long-term effects are warranted.
强制性诱导运动疗法（CIMT）联合重复经颅磁刺激（rTMS）在改善因围产期卒中导致的单侧脑瘫学龄儿童的功能方面已显示出巨大潜力。然而，在因各种脑部疾病导致的单侧脑瘫（UCP）学龄前儿童中的应用前景仍不明确。在这项前瞻性、评估者盲法、随机对照研究中，40名UCP学龄前儿童（年龄2.5 - 6岁）被随机分为两组，分别接受为期10天的CIMT联合主动或 sham rTMS治疗。在基线、干预后2周和6个月进行评估，以调查上肢功能、社交生活能力以及家长感知的变化和运动诱发电位。总体而言，35名参与者完成了试验。CIMT加主动刺激组在患手功能（运动范围、准确性和流畅性）方面的改善比CIMT加 sham刺激组更大（<0.05），但两组之间在肌张力、社交生活能力以及家长感知的变化方面无显著差异（>0.05）。此外，有或无运动诱发电位的儿童在手部功能方面无显著差异（>0.05）。研究期间没有参与者报告严重不良事件。简而言之，CIMT联合rTMS治疗对于因各种脑部疾病导致的UCP学龄前儿童是安全可行的。有必要进行大样本和长期效应的随机对照研究。
