首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Efficacy of constraint-induced movement therapy for children with cerebral palsy with asymmetric motor impairment.
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Efficacy of constraint-induced movement therapy for children with cerebral palsy with asymmetric motor impairment.

机译:约束性运动疗法对不对称运动障碍脑瘫患儿的疗效。

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OBJECTIVE: Constraint-Induced Movement (CI) therapy has been found to be a promising treatment for substantially increasing the use of extremities affected by such neurologic injuries as stroke and traumatic brain injury in adults. The purpose of this study was to determine the applicability of this intervention to young children with cerebral palsy. METHODS: A randomized, controlled clinical trial of pediatric CI therapy in which 18 children with diagnosed hemiparesis associated with cerebral palsy (7-96 months old) were randomly assigned to receive either pediatric CI therapy or conventional treatment. Pediatric CI therapy involved promoting increased use of the more-affected arm and hand by intensive training (using shaping) of the more-impaired upper extremity for 6 hours/day for 21 consecutive days coupled with bivalved casting of the child's less-affected upper extremity for that period. Children's functional upper-extremity skills were assessed in the laboratory (blinded scoring) and at home (parent ratings) just prior, after, and 3 weeks posttreatment. Treated children were followed for 6 months. RESULTS: Children receiving pediatric CI therapy compared with controls acquired significantly more new classes of motoric skills (9.3 vs 2.2); demonstrated significant gains in the mean amount (2.1 vs 0.1) and quality (1.7 vs 0.3) of more-affected arm use at home; and in a laboratory motor function test displayed substantial improvement including increases in unprompted use of the more-affected upper extremity (52.1% vs 2.1% of items). Benefits were maintained over 6 months, with supplemental evidence of quality-of-life changes for many children. CONCLUSION: Pediatric CI therapy produced major and sustained improvement in motoric function in the young children with hemiparesis in the study.
机译:目的:发现约束诱导运动(CI)治疗是一种有前途的治疗方法,可以显着增加成年人使用中风和颅脑外伤等神经系统损伤所致四肢的使用。这项研究的目的是确定这种干预措施对脑瘫幼儿的适用性。方法:一项儿科CI疗法的随机对照临床试验,其中18例被诊断为脑瘫伴偏瘫的儿童(7-96个月大)被随机分配接受儿科CI疗法或常规治疗。小儿CI治疗涉及通过连续训练21天,每天对每天6小时/天的重度受损的上肢进行强化训练(使用塑形),以促进对患病的手臂和手的更多使用,同时对患病较少的上肢进行双瓣式铸造在那个时期。在治疗前,治疗后和治疗后3周,分别在实验室(盲目评分)和在家(父母评分)中评估了儿童的功能性上肢技能。接受治疗的儿童随访了6个月。结果:与对照组相比,接受小儿CI疗法的儿童获得了更多的新的运动技能(9.3 vs 2.2);事实证明,在家中受影响较大的手臂使用的平均数量(2.1比0.1)和质量(1.7比0.3)有了显着提高;在实验室进行的运动功能测试显示出实质性的改善,包括未受影响的上肢无提示使用的增加(52.1%比项目的2.1%)。收益维持了6个月以上,补充证据表明许多儿童的生活质量发生了变化。结论:在这项研究中,小儿CI疗法对偏瘫轻症儿童的运动功能产生了重大且持续的改善。

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