Pham Van Minh, Hoang Thi Lien, Hoang Khanh Chi, Nguyen Ngoc-Minh, DeLuca Stephanie C, Coker-Bolt Patty
Rehabilitation Department, Ha Noi Medical University, Hanoi, Vietnam.
Ha Noi Rehabilitation Hospital, Hanoi, Vietnam.
Disabil Rehabil. 2025 Feb;47(4):912-918. doi: 10.1080/09638288.2024.2360060. Epub 2024 Jun 3.
Pediatric constraint-induced movement therapy (CIMT) is an evidence-based treatment that has a long history of demonstrating efficacy for children with hemiparesis. The purpose of this study is to determine the effectiveness of a culturally responsive CIMT program for children with hemiplegic cerebral palsy (CP) developed for the Vietnam healthcare system.
Thirty children with hemiplegic CP (mean age = 2.88 years, age range: 1 to 8 yrs, 60% male) were recruited to a CIMT program (7.5 h/week, 4 weeks) developed for the cultural context of Vietnam. Motor abilities of the affected arm and participation in daily activities were evaluated at 3 time points (one-week prior to CIMT (baseline), one-week before (pre) and after (post) CIMT) using the Quality of Upper Extremity Skill Test (QUEST) and Pediatric Motor Activity Log-Revised (PMAL-R). Individual goals were measured using the Goal Attainment Scale (GAS).
There were significant increases in the "How often scale" and "How Well" scales of the PMAL-R (0.75 and 0.75, < 0.00)). Score of Grasp and Dissociated Movement items on the QUEST increased significantly (6.47 and 7.63, < 0.001). Group GAS T-Scores were 52.19 indicating that children met individual goals.
A model of CIMT was successfully developed and delivered within the Vietnamese healthcare system. Future studies should explore the optimal model for CIMT in various regions of world where the delivery of rehabilitation services may vary.
小儿强制性运动疗法(CIMT)是一种循证治疗方法,长期以来已证明对偏瘫儿童有效。本研究的目的是确定为越南医疗系统开发的针对偏瘫型脑瘫(CP)儿童的具有文化适应性的CIMT方案的有效性。
招募了30名偏瘫型CP儿童(平均年龄 = 2.88岁,年龄范围:1至8岁,60%为男性)参加为越南文化背景开发的CIMT方案(每周7.5小时,共4周)。在3个时间点(CIMT前一周(基线)、CIMT前一周(治疗前)和CIMT后(治疗后))使用上肢技能质量测试(QUEST)和修订后的小儿运动活动日志(PMAL-R)评估患侧手臂的运动能力和日常活动参与情况。使用目标达成量表(GAS)测量个体目标。
PMAL-R的“频率量表”和“程度量表”有显著增加(分别为0.75和0.75,P < 0.001)。QUEST上的抓握和分离运动项目得分显著提高(分别为6.47和7.63,P < 0.001)。组GAS T分数为52.19,表明儿童达到了个体目标。
在越南医疗系统内成功开发并实施了一种CIMT模式。未来的研究应探索在世界不同地区提供康复服务可能存在差异的情况下CIMT的最佳模式。