School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei.
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei.
Neurorehabil Neural Repair. 2023 Feb-Mar;37(2-3):109-118. doi: 10.1177/15459683231162330. Epub 2023 Mar 28.
Previous studies have compared the effectiveness of constraint-induced movement therapy (CIMT) by different training doses. However, whether the dosing schedule, that is, intensive or distributed, influences the effectiveness of CIMT in children with unilateral cerebral palsy (CP) is unknown.
To investigate the effectiveness of intensive and distributed CIMT for children with unilateral CP.
Fifty children with unilateral CP were assigned to intensive or distributed CIMT group with a total of 36 training hours. The intensive CIMT was delivered within 1 week, and the distributed CIMT was delivered twice a week for 8 weeks. The outcomes were the Melbourne Assessment 2, Box and Block Test, Pediatric Motor Activity Log-Revised (PMAL-R), Bruininks-Oseretsky test of motor proficiency 2, ABILHAND-Kids and Parenting Stress Index-Short Form. The intensive group was assessed at the initiation of treatment (week 0), at the end of 1 week treatment (week 1), and 8 weeks after the initiation of treatment (week 8). The distributed group was assessed at week 0 and week 8.
The within-group analyses demonstrated significant differences on all motor outcomes. There were no significant between-group differences at post-treatment, while the intensive CIMT demonstrated larger improvements than the distributed CIMT did on quality of use of the more-affected hand, as rated by parents on the PMAL-R at week 8.
The 2 dosing schedules of CIMT had similar effectiveness for children with unilateral CP. The intensive CIMT yielded additional improvement on parent rated motor quality of the more-affected hand at 8 weeks after the initiation of treatment.
ClinicalTrials.gov (ID: NCT03128385).
先前的研究比较了不同训练剂量的强制性运动疗法（CIMT）的有效性。然而，剂量方案（即集中式或分布式）是否会影响单侧脑瘫（CP）儿童的 CIMT 有效性尚不清楚。
研究集中式和分布式 CIMT 对单侧 CP 儿童的有效性。
将 50 名单侧 CP 儿童分配到集中式或分布式 CIMT 组，总训练时间为 36 小时。集中式 CIMT 在 1 周内完成，分布式 CIMT 每周两次，共 8 周。结果为墨尔本评估 2、箱和块测试、儿童运动活动日志修订版（PMAL-R）、布鲁因克斯-奥塞尔斯基运动技能测试 2、ABILHAND-Kids 和父母压力指数-短表。集中组在治疗开始时（第 0 周）、治疗 1 周结束时（第 1 周）和治疗开始 8 周后（第 8 周）进行评估。分布式组在第 0 周和第 8 周进行评估。
组内分析显示所有运动结果均有显著差异。治疗后无显著组间差异，而集中式 CIMT 在治疗开始 8 周后，父母在 PMAL-R 上对受影响较大的手的使用质量的评分中，显示出比分布式 CIMT 更大的改善。
CIMT 的 2 种给药方案对单侧 CP 儿童的疗效相似。在治疗开始 8 周后，集中式 CIMT 对受影响较大的手的父母评定运动质量有额外的改善。
ClinicalTrials.gov（ID：NCT03128385）。
