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强制性运动疗法治疗脑瘫相关偏瘫儿童的疗效:系统评价。

Effectiveness of Constraint-Induced Movement Therapy for Children With Hemiparesis Associated With Cerebral Palsy: A Systematic Review.

机构信息

Adam Regalado, BS, is Student, Occupational Therapy, Gannon University, Ruskin, FL;

Bonnie Decker, EdD, OTR/L, FAOTA, is Associate Professor, Occupational Therapy, Gannon University, Ruskin, FL.

出版信息

Am J Occup Ther. 2023 May 1;77(3). doi: 10.5014/ajot.2023.050152.

Abstract

IMPORTANCE

This systemic review synthesizes the existing literature to determine whether constraint-induced movement therapy (CIMT) is more effective than other approaches in improving upper extremity function in children diagnosed with hemiparesis associated with cerebral palsy (CP).

OBJECTIVE

To advance the knowledge of the effectiveness of CIMT for occupational therapy practitioners by critiquing research conducted over the past 20 yr.

DATA SOURCES

Databases used in the search were CINAHL, Health Source: Nursing/Academic Edition, PsycINFO, PubMed, Research Gate, and Google Scholar. Studies published from 2001 to 2021 were reviewed.

STUDY SELECTION AND DATA COLLECTION

Articles were included if (1) the primary diagnosis was hemiparesis associated with CP; (2) participants were younger than age 21 yr; (3) constraint-induced therapy, CIMT, or other modified forms of CIMT were offered as an intervention; and (4) there was at least one group in the study.

FINDINGS

Forty studies were included in the analysis. The results demonstrate that CIMT produces improved affected upper extremity function when compared with general rehabilitation. However, there were no differences in outcomes when bimanual approaches were compared with CIMT.

CONCLUSIONS AND RELEVANCE

The data support that CIMT is a beneficial and effective treatment when used to improve the upper extremity function of children with hemiparesis associated with CP. However, more Level 1b studies are needed to compare CIMT with bimanual therapy to determine which one is most effective and under which conditions. What This Article Adds: This systematic review demonstrates that CIMT is an effective intervention when compared with other therapeutic approaches. This intervention can be used by occupational therapy practitioners who work with children diagnosed with hemiparesis associated with CP.

摘要

重要性

本系统评价综合了现有文献,以确定强制性运动疗法(CIMT)是否比其他方法更能改善脑瘫相关偏瘫儿童的上肢功能。

目的

通过评价过去 20 年的研究,为职业治疗师提供有关 CIMT 有效性的知识。

数据来源

用于搜索的数据库包括 CINAHL、Health Source: Nursing/Academic Edition、PsycINFO、PubMed、Research Gate 和 Google Scholar。审查了 2001 年至 2021 年发表的文章。

研究选择和数据收集

如果(1)主要诊断为脑瘫相关偏瘫;(2)参与者年龄小于 21 岁;(3)约束诱导治疗、CIMT 或其他改良形式的 CIMT 作为干预措施;(4)研究中有至少一个组,则将文章纳入分析。

发现

有 40 项研究纳入了分析。结果表明,与一般康复相比,CIMT 可改善受影响的上肢功能。然而,当比较双手方法与 CIMT 时,结果没有差异。

结论和相关性

数据支持 CIMT 是一种有益且有效的治疗方法,可用于改善脑瘫相关偏瘫儿童的上肢功能。然而,需要更多的 1b 级研究来比较 CIMT 与双手治疗,以确定哪种方法最有效以及在哪些条件下最有效。这篇文章增加了什么:本系统评价表明,与其他治疗方法相比,CIMT 是一种有效的干预措施。从事脑瘫相关偏瘫儿童诊断的职业治疗师可以使用这种干预措施。

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