Spared Primary Motor Cortex and The Presence of MEP in Cerebral Palsy Dictate the Responsiveness to tDCS during Gait Training Lycra(®) arm splints improve movement fluency in children with cerebral palsy. Lycra arm splints in conjunction with goal-directed training can improve movement in children with cerebral palsy. Effects on motor development of kicking and stepping exercise in preterm infants with periventricular brain injury: a pilot study. Action Observation Treatment Improves Upper Limb Motor Functions in Children with Cerebral Palsy: A Combined Clinical and Brain Imaging Study A Low-Cost Video Game Applied for Training of Upper Extremity Function in Children with Cerebral Palsy: A Pilot Study Muscle Strengthening in Children and Adolescents With Spastic Cerebral Palsy: Considerations for Future Resistance Training Protocols No change in calf muscle passive stiffness after botulinum toxin injection in children with cerebral palsy Effect of Autologous Cord Blood Infusion on Motor Function and Brain Connectivity in Young Children with Cerebral Palsy: A Randomized, Placebo‐Controlled Trial Combining strength training and botulinum neurotoxin intervention in children with cerebral palsy: the impact on muscle morphology and strength Chorioamnionitis and cerebral palsy in term and near-term infants. Randomized controlled trial of physiotherapy in 56 children with cerebral palsy followed for 18 months. Improving upper limb motor functions through action observation treatment: a pilot study in children with cerebral palsy. Botulinum toxin assessment, intervention and after-care for lower limb spasticity in children with cerebral palsy: international consensus statement. Effects of intrathecal baclofen on daily care in children with secondary generalized dystonia: a pilot study. Efficacy of the small step program in a randomised controlled trial for infants below age 12 months with clinical signs of CP; a study protocol Regulation of stretch reflex threshold in elbow flexors in children with cerebral palsy: a new measure of spasticity. Video-game based therapy performed by children with cerebral palsy: a cross-over randomized controlled trial and a cross-sectional quantitative measure of physical activity. The Effects of Therapeutic Taping on Gross Motor Function in Children with Cerebral Palsy Modified Constraint-Induced Movement Therapy combined with Bimanual Training (mCIMT-BiT) in children with unilateral spastic cerebral palsy: how are improvements in arm-hand use established? The effects of Kinesio Taping on body functions and activity in unilateral spastic cerebral palsy: a single-blind randomized controlled trial. Effects of Neural Progenitor Cell Transplantation in Children with Severe Cerebral Palsy Effect of Treadmill Training with Body Weight Support on Gait and Gross Motor Function in Children with Spastic Cerebral Palsy
The current priority of investigations involving transcranial direct current stimulation ( tDCS ) and neurorehabilitation is to identify biomarkers associated with the positive results of the interventions such that respondent and non-respondent patients can be identified in the early phases of treatment . The aims were to determine whether : ( 1 ) present motor evoked potential ( MEP ) ; and ( 2 ) injuries involving the primary motor cortex , are associated with tDCS-enhancement in functional outcome following gait training in children with cerebral palsy ( CP ) . We review ed the data from our parallel , r and omized , sham-controlled , double-blind studies . Fifty-six children with spastic CP received gait training ( either treadmill training or virtual reality training ) and tDCS ( active or sham ) . Univariate and multivariate logistic regression analyses were employed to identify clinical , neurophysiologic and neuroanatomic predictors associated with the responsiveness to treatment with tDCS .  MEP presence during the initial evaluation and the subcortical injury were associated with positive effects in the functional results . The logistic regression revealed that present MEP was a significant predictor for the six-minute walk test ( 6MWT ; p = 0.003 ) and gait speed ( p = 0.028 ) , whereas the subcortical injury was a significant predictor of gait kinematics ( p = 0.013 ) and gross motor function ( p = 0.021 ) . In this preliminary study involving children with CP , two important prediction factors of good responses to anodal tDCS combined with gait training were identified . Apparently , MEP ( integrity of the corticospinal tract ) and subcortical location of the brain injury exerted different influences on aspects related to gait , such as velocity and kinematics AIMS To determine changes in upper limb movement substructures that denote fluency of movement in children with cerebral palsy ( CP ) following lycra ( ® ) splint wear  . Secondarily , to explore the efficacy of lycra ( ® ) splints for those with spastic and dystonic hypertonia . DESIGN R and omised clinical trial whereby participants were r and omised to parallel groups with waiting list control . METHOD Sixteen children ( mean age 11.5 years SD=2.2 ) with hypertonic upper limb involvement ( 13 hemiplegia , 4 quadriplegia ) were recruited . Children were r and omly allocated either to a control group or to wear the lycra ( ® ) splint for a period of three months . Three-dimensional ( 3D ) upper limb kinematics was used to assess four functional tasks at baseline , on initial lycra ( ® ) splint application , three months after lycra ( ® ) splint wear , and immediately after splint removal . Movement substructures of the motion of the wrist joint center were analysed . RESULTS A significant difference was observed between baseline and three months of lycra ( ® ) splint wear in the movement substructures ; movement time , percentage of time and distance in primary movement , jerk index , normalised jerk and percentage of jerk in primary and secondary movements . The magnitude of changes in normalised jerk and the percentage of jerk in the primary movement from baseline to three months was greatest in children with dystonic hypertonia . CONCLUSIONS The results indicate that lycra ( ® ) arm splinting induced significant changes in movement substructures and motor performance in children with CP . This research demonstrates that fluency of movement can be quantified and is amenable to change with intervention OBJECTIVES To investigate the effects of lycra ® arm splint wear on goal attainment and three dimensional ( 3D ) kinematics of the upper limb and trunk in children with cerebral palsy ( CP ) . DESIGN R and omised clinical trial whereby participants were r and omised to parallel groups with waiting list control . PARTICIPANTS Sixteen children with CP ( hypertonia ) aged 9 to 14 years . INTERVENTION Three months lycra arm splint wear combined with goal directed training . MAIN OUTCOME MEASURE Goal attainment scale , and 3D upper limb and trunk kinematics across four upper limb movement tasks . RESULTS 17/18 children achieved their movement goals following three months of splinting . Selected joint kinematics improved on immediate splint application . Further improvements in joint kinematics were demonstrated following 3 months of splint wear , particularly in elbow extension , shoulder flexion and abduction and in thorax flexion . Only improvements in movement compensations at the thorax remained following removal of the splint . CONCLUSIONS The lycra ® arm splint , made a quantifiable change to the attainment of movement goals of importance to the child . Furthermore , improvements were demonstrated in selected maximum range of movement and joint kinematics during functional tasks at the elbow and shoulder joints and thorax segment in children with CP BACKGROUND Preterm infants with periventricular brain injury ( PBI ) have a high incidence of atypical development and leg movements . OBJECTIVE Determine whether kicking and treadmill stepping intervention beginning at 2 months corrected age ( CA ) in children with PBI improves motor function at 12 months CA when compared with control subjects . METHOD In a multi-center pilot study for a controlled clinical trial , sixteen infants with PBI were r and omly assigned to home exercise consisting of kicking and treadmill stepping or a no-training control condition . Development was assessed at 2 , 4 , 6 , 10 , and 12 months CA with the Alberta Infant Motor Scale ( AIMS ) . At 12 months children were classified as normal , delayed , or with cerebral palsy ( CP ) . RESULTS At 12 months CA 3 of 7 ( 43 % ) of the exercise group children walked alone or with one h and held versus 1 of 9 ( 11 % ) in the control group ( p=0.262 ) , but no significant differences in AIMS scores were found at any age . Half of the subjects had CP or delay ; the outcomes of these infants were not improved by exercise . Compliance with the home program was lower than requested and may have affected results . CONCLUSION Although not statistically significant with a small sample size , self-produced kicking and treadmill exercise may lower age at walking in infants with normal development following PBI , but improvements of the protocol to increase and document compliance are needed before a larger study is implemented The aim of the present study was to assess the role of action observation treatment ( AOT ) in the rehabilitation of upper limb motor functions in children with cerebral palsy . We carried out a two-group , parallel r and omized controlled trial . Eighteen children ( aged 5–11 yr ) entered the study : 11 were treated children , and 7 served as controls . Outcome measures were scores on two functional scales : Melbourne Assessment of Unilateral Upper Limb Function Scale ( MUUL ) and the Assisting H and Assessment ( AHA ) . We collected functional scores before treatment ( T1 ) , at the end of treatment ( T2 ) , and at two months of follow-up ( T3 ) . As compared to controls , treated children improved significantly in both scales at T2 and this improvement persisted at T3 . AOT has therefore the potential to become a routine rehabilitation practice in children with CP . Twelve out of 18 enrolled children also underwent a functional magnetic resonance study at T1 and T2 . As compared to controls , at T2 , treated children showed stronger activation in a parieto-premotor circuit for h and -object interactions . These findings support the notion that AOT contributes to reorganize brain circuits subserving the impaired function rather than activating supplementary or vicariating ones The aim of the present study was to determine the user satisfaction of the EyeToy for the training of the upper limb in children with cerebral palsy ( CP ) .  User satisfaction was measured in 12 children with CP , using a postexperience question naire , primarily based on a presence question naire . In general , children with CP were satisfied with and motivated by the EyeToy training . In addition , a first evaluation study was performed to determine the effect of this training method on the upper limb function . Ten children with CP were r and omly assigned to the intervention ( mean age 11 years , 9 months ; SD 2,3 ) and the control group ( mean age 12 years , 3 months ; SD 3,2 ) . After a treatment period of 6 weeks , the intervention group completed a  user satisfaction question naire . Functional outcome was measured using the Melbourne Assessment scores . Percentage scores of the Melbourne Assessment of 7 of the 10 children were the same or changed only 1 % to 2 % from baseline to followup . However , in the experimental group , two children improved more , 9 % and 13 % respectively . In conclusion , it can be said that the EyeToy is a motivational training tool for the training of children with CP and has the potential to improve upper extremity function Resistance training of the lower limbs is now commonly used in clinical practice in children and adolescents with spastic cerebral palsy ( CP ) . However , the effectiveness of this type of training is still disputed . The most recently published systematic review with meta- analysis included interventions such as electrical stimulation and resistance training and found insufficient evidence to support or refute the efficacy of these exercises in children with CP . Thus , the aim of this article is to evaluate the extent to which training protocol s from the most recent r and omized controlled trials are in keeping with the evidence for effective resistance  training in children who are developing typically , as reflected in the training guidelines of the National Strength and Conditioning Association . Recommendations for resistance training protocol s , based on this evidence and appropriate to children with CP , are provided to help guide both future research and clinical practice for resistance training in children with CP Aim Stiffness and shortening of the calf muscle due to neural or mechanical factors can profoundly affect motor function . The aim of this study was to investigate non‐neurally mediated calf‐muscle tightness in children with cerebral palsy ( CP ) before and after botulinum toxin type A ( BoNT‐A ) injection Abstract Cerebral palsy ( CP ) is a condition affecting young children that causes lifelong disabilities . Umbilical cord blood cells improve motor function in experimental systems via paracrine signaling . After demonstrating safety , we conducted a phase II trial of autologous cord blood ( ACB ) infusion in children with CP to test whether ACB could improve function ( Clinical Trials.gov , NCT01147653 ; IND 14360 ) . In this double‐blind , placebo‐controlled , crossover study of a single intravenous infusion of 1–5 × 107 total nucleated cells per kilogram of ACB , children ages 1 to 6 years with CP were r and omly assigned to receive ACB or placebo at baseline , followed by the alternate infusion 1 year later . Motor function and magnetic resonance imaging brain connectivity studies were performed at baseline , 1 , and 2 years post‐treatment . The primary endpoint was change in motor function 1 year after baseline infusion . Additional analyses were performed at 2 years . Sixty‐three children ( median age 2.1 years ) were r and omized to treatment ( n = 32 ) or placebo ( n = 31 ) at baseline . Although there was no difference in mean change in Gross Motor Function Measure‐66 ( GMFM‐66 ) scores at 1 year between placebo and treated groups , a dosing effect was identified . In an analysis 1 year post‐ACB treatment , those who received doses ≥2 × 107/kg demonstrated significantly greater increases in GMFM‐66 scores above those predicted by age and severity , as well as in Peabody Developmental Motor Scales‐2 Gross Motor Quotient scores and normalized brain connectivity . Results of this study suggest that appropriately dosed ACB infusion improves brain connectivity and gross motor function in young children with CP . Stem Cells Translational Medicine Purpose : Investigate the combination effects of strength training and Botulinum Toxin Type-A ( BoNT-A ) on muscle strength and morphology in children with Cerebral Palsy ( CP ) . Methods : Fifteen children receiving BoNT-A , classified as Spastic Diplegic CP , GMFCS I-II , and aged 5–12 years were recruited for this study . R and omly allocated to 10 weeks of strength training either before or after BoNT-A , children were assessed over 6 months . Eight of the 15 children also completed a control period . The Modified Ashworth Scale measured spasticity . The Goal Attainment Scale ( GAS ) assessed achievement of functional goals . Magnetic Resonance Imaging assessed muscle volume ( MV ) . Instrumented dynamometry assessed strength . Results : Spasticity was significantly reduced following BoNT-A injection ( p = 0.033 ) . Children made significant isokinetic strength gains ( mean p = 0.022 , ES = 0.57 ) in the intervention period compared to the control period ( mean p = 0.15 , ES = 0.56 ) . Irrespective of timing , significant strength improvements were seen immediately ( 10 weeks ) and over 6 months for all children . This was also the case for improvements in the GAS ( immediately : mean p = 0.007 , ES = 4.17 , 6 months : mean p = 0.029 , ES = 0.99 ) , and improvements in MV in all assessed muscles . Conclusion : The simultaneous use of BoNT-A and strength training was successful in spasticity reduction , improving strength and achieving functional goals , over and above treatment with BoNT-A alone . Muscles targeted for BoNT-A injection should be included in strength training . Implication s for Rehabilitation Cerebral Palsy Botulinum toxin type-A ( BoNT-A ) and strength training are available interventions that , on their own have found success in managing spasticity and muscle weakness ( both significant motor impairments ) , respectively in children with Cerebral Palsy ( CP ) . This study has demonstrated that the concurrent treatment of BoNT-A and strength training can achieve positive outcomes in terms of strength , spasticity and for the achievement of set functional goals . The results of this study show that the improved muscle strength can be associated with hypertrophy , which could indicate the potential role of strength training in altering the rate of muscle growth , in an aim to improve the failure of muscle growth associated with CP . Home based strength training , based on a child ’s individual goals is shown to be successful in improving strength and goal attainment for children with CP CONTEXT Half of all cases of cerebral palsy ( CP ) occur in term infants , for whom risk factors have not been clearly defined . Recent studies suggest a possible role of chorioamnionitis . OBJECTIVE To determine whether clinical chorioamnionitis increases the risk of CP in term and near-term infants . DESIGN , SETTING , AND PATIENTS Case-control study nested within a cohort of 231 582 singleton infants born at 36 or more weeks ' gestation between January 1 , 1991 , and December 31 , 1998 , in the Kaiser Permanente Medical Care Program , a managed care organization providing care for more than 3 million residents of northern California . Case patients were identified from electronic records and confirmed by chart review by a child neurologist , and comprised all children with moderate to severe spastic or dyskinetic CP not due to postnatal brain injury or developmental abnormalities ( n = 109 ) . Controls ( n = 218 ) were r and omly selected from the study population . MAIN OUTCOME MEASURE Association between clinical chorioamnionitis and increased risk of CP in term and near-term infants  . RESULTS Most CP cases had hemiparesis ( 40 % ) or quadriparesis ( 38 % ) ; 87 % had been diagnosed by a neurologist and 83 % had undergone neuroimaging .  Chorioamnionitis  , considered present if a treating physician made a diagnosis of chorioamnionitis or endometritis clinical ly , was noted in 14 % of cases and 4 % of controls ( odds ratio [ OR ] , 3.8 ; 95 % confidence interval [ CI ] , 1.5 - 10.1 ; P = .001 ) . Independent risk factors identified in multiple logistic regression included chorioamnionitis ( OR , 4.1 ; 95 % CI , 1.6 - 10.1 ) , intrauterine growth restriction ( OR , 4.0 ; 95 % CI , 1.3 - 12.0 ) , maternal black ethnicity ( OR , 3.6 ; 95 % CI , 1.4 - 9.3 ) , maternal age older than 25 years ( OR , 2.6 ; 95 % CI , 1.3 - 5.2 ) , and nulliparity ( OR , 1.8 ; 95 % CI , 1.0 - 3.0 ) . The population -attributable fraction of chorioamnionitis for CP is 11 % . CONCLUSION Our data suggest that chorioamnionitis is an independent risk factor for CP among term and near-term infants This study aim ed to determine whether motor function and performance is better enhanced by intensive physiotherapy or collaborative goal - setting in children with cerebral palsy ( CP ) . Participants were a convenience sample of 56 children with bilateral CP classified at level III or below on the Gross Motor Function Classification System ( GMFCS ) , aged between 3 and 12 years . A 2 x 2 factorial design was used to compare the effects of routine amounts of physiotherapy with intensive amounts , and to compare the use of generalized aims set by the child 's physiotherapist with the use of specific , measurable goals negotiated by the child 's physiotherapist with each child , carer , and teacher . Following the six-month treatment period there was a further six-month period of observation . Changes in motor function and performance were assessed by a masked assessor using the Gross Motor Function Measure ( GMFM ) and the Gross Motor Performance Measure ( GMPM ) at three-month intervals . There was no statistically significant difference in the scores achieved between intensive and routine amounts of therapy or between aim -directed and goal -directed therapy  in either function or performance . Inclusion of additional covariates of age and severity levels showed a trend towards a statistically significant difference in children receiving intensive therapy during the treatment period . This advantage declined over the subsequent six months during which therapy had reverted to its usual amount . Differences in goal - setting procedures did not produce any detectable effect on the acquisition of gross motor function or performance AIM The aim of this r and omized controlled trial was to assess whether action observation treatment may improve upper limb motor functions in children with cerebral palsy ( CP ) . METHOD All children with CP admitted to our unit for rehabilitation from May 2009 to May 2010 were eligible . Inclusion criteria were age between 6 years and 11 years , an IQ of at least 70 , and no major visual and /or auditory deficits . Fifteen children were enrolled and r and omly assigned to either a case group ( n=8 ; four males , four females ; median age 7 y 6 mo ) or control group ( n=7 ; five males , two females ; median age 8 y ) . Six participants had left-sided hemiplegia , six right-sided hemiplegia , and three had tetraplegia ; 10 were independent walkers . Those in the case group were asked to observe video clips showing daily age-appropriate actions , and afterwards to imitate them . Participants in the control group were asked to observe video clips with no motor content and afterwards to execute the same actions as cases . The primary outcome measure was the Melbourne Assessment Scale . Children were scored twice at baseline ( 2 wks apart ) , and at the end of treatment , by a physician blind to group assignment . RESULTS At baseline groups did not differ on functional evaluation . After treatment , the functional score gain ( Δ ) was significantly different in the case and control groups ( p=0.026 ) . INTERPRETATION The present results support the notion that action observation treatment can be an effective part of the rehabilitation programme in children with CP Botulinum neurotoxin type-A ( BoNT-A ) has been used in association with other interventions in the management of  spasticity in children with cerebral palsy ( CP ) for almost two decades . This consensus statement is based on an extensive review of the literature by an invited international committee . The use of BoNT-A in the lower limbs of children with spasticity caused by CP is reported using the American Academy of Neurology Classification of Evidence for therapeutic intervention . R and omized clinical trials have been grouped into five areas of management , and the outcomes are presented as treatment recommendations . The assessment of children with CP and evaluation of outcomes following injection of BoNT-A are complex , and therefore , a range of measures and the involvement of a multidisciplinary team is recommended . The committee concludes that injection of BoNT-A in children with CP is generally safe although systemic adverse events may occur , especially in children with more physical limitations ( GMFCS V ) . The recommended dose levels are intermediate between previous consensus statements . The committee further concludes that injection of BoNT-A is effective in the management of lower limb spasticity in children with CP , and when combined with physiotherapy and the use of orthoses , these interventions may improve gait and goal attainment AIM Treatment options for dystonic cerebral palsy ( CP ) are limited . Our aims were to determine whether intrathecal baclofen ( ITB ) improves daily care , decreases dystonia and decreases pain in patients with dystonic CP . METHODS Patients received r and omized blinded treatment with ITB or placebo . Scores on problems of daily care were recorded and dystonia , pain and comfort were assessed . RESULTS Four patients ( three males , average age 12 years 6 months ) were included ( all Gross Motor Function Classification System level V ) . During the trial period problem scores and dystonia scores decreased in all four patients . CONCLUSION In this pilot study we report positive functional effects of ITB trial treatment in four patients with dystonic CP . A r and omized trial with a larger cohort is needed to verify these results Background Children with cerebral palsy ( CP ) have life-long motor disorders , and they are typically subjected to extensive treatment throughout their childhood . Despite this , there is a lack of evidence supporting the effectiveness of early interventions aim ing at improving motor function , activity , and participation in daily life . The study will evaluate the effectiveness of the newly developed Small Step Program , which is introduced to children at risk of developing CP during their first year of life . The intervention is based upon theories of early learning-induced brain plasticity and comprises important components of evidence -based intervention approaches used with older children with CP . Method and design A two-group r and omised control trial will be conducted . Invited infants at risk of developing CP due to a neonatal event affecting the brain will be r and omised to either the Small Step Program or to usual care . They will be recruited from Astrid Lindgren Children ’s Hospital at regular check-up and included at age 3–8 months . The Small Step Program was design ed to provide individualized , goal directed , and intensive intervention focusing on h and use , mobility , and communication in the child ’s own home environment and carried out by their parents who have been trained and coached by therapists . The primary endpoint will be approximately 35 weeks after the start of the intervention , and the secondary endpoint will be at 2 years of age . The primary outcome measure will be the Peabody Developmental Motor Scale ( second edition ) . Secondary assessment s will measure and describe the children ’s general and specific development and brain pathology . In addition , the parents ’ perspective of the program will be evaluated . General linear models will be used to compare outcomes between groups . Discussion This paper presents the background and rationale for developing the Small-Step Program and the design and protocol of a r and omized controlled trial . The aim of the Small Step Program is to influence development by enabling children to function on a higher level than if not treated by the program and to evaluate whether the program will affect parent ’s ability to cope with stress and anxiety related to having a child at risk of developing CP.Trial registration Clinical Trials.gov Identifier NCT02166801 . Registered June 12 , 2014 The tonic stretch reflex threshold in children with cerebral palsy ( CP ) was measured to determine its test-retest reliability and its concurrent validity as a potential measure of spasticity . Fourteen children with spastic CP aged 6 to 18 years were tested on three separate occasions for clinical spasticity and stretch reflex thresholds of affected elbow flexors .  Electromyographic ( EMG ) recordings were obtained by surface electrodes for elbow flexors and extensors during mechanical displacements of the passive joint towards extension . Displacements were produced by a torque motor at seven velocities which r and omly varied from trial to trial . EMG activity was measured in the stretched flexor muscles to determine threshold angles and velocities for each velocity of stretch . These were plotted on a velocity-angle-phase diagram and regression analysis was used to determine the static stretch reflex threshold for each participant . The measure showed good test-retest reliability for the group ( ICC 0.73 , p<0.001 ) whereas a significant correlation between the measure and the clinical spasticity scale was not found . This technique is a potential outcome variable for measuring the efficacy of treatments aim ed at decreasing spasticity in children with CP BACKGROUND Previous studies reported controversial results about the efficacy of video-game based therapy ( VGT ) in improving neurorehabilitation outcomes in children with cerebral palsy ( CP ) . AIM Primary aim was to investigate the effectiveness of VGT with respect to conventional therapy ( CT ) in improving upper limb motor outcomes in a group of children with CP . Secondary aim was to quantify if VGT leads children to perform a higher number of movements . DESIGN A cross-over r and omized controlled trial ( RCT ) for investigating the primary aim and a cross-sectional study for investigating the secondary aim of this study . SETTING S Out patients . POPULATION INCLUSION CRITERIA clinical diagnosis of CP , age between 4 and 14 years , level of GMFC between I and IV . EXCLUSION CRITERIA QI<35 , severe comorbidities , incapacity to st and even with an external support . METHODS Twenty-two children with CP ( 6.89±1.91-year old ) were enrolled in a cross-over RCT with 16 sessions of VGT ( using Xbox with Kinect device ) and then 16 of CT or vice versa . Upper limb functioning was assessed using the Quality of Upper Extremities Skills Test ( QUEST ) and h and abilities using Abilh and -kids score . According to the secondary aim of this study a secondary cross-sectional study has been performed . Eight children with CP ( 6.50±1.60-year old ) were enrolled into a trial in which five wireless triaxial accelerometers were positioned on their forearms , legs and trunk for quantifying the physical activity during VGT vs. CT .  RESULTS QUEST scores significantly improved only after VGT ( P=0.003 ) , and not after CT ( P=0.056 ) . The reverse occurred for Abilh and -kids scores ( P=0.165 vs. P=0.013 , respectively ) . Quantity of performed movements was three times higher in VGT than in CT ( + 198 % , P=0.027 ) . CONCLUSION VGT result ed effective in improving the motor functions of upper limb extremities in children with CP , conceivably for the increased quantity of limb movements , but failed in improving the manual abilities for performing activities of daily living which benefited more from CT . CLINICAL REHABILITATION IMPACT VGT performed using the X-Box with Kinect device could enhance the number of upper limb movements in children with CP during rehabilitation and in turn improving upper limb motor skills , but CT remained superior for improving performances in manual activities of daily living Purpose : Therapeutic taping to address dysfunctional sitting control in children with cerebral palsy ( CP ) was investigated in this study . Methods : Eighteen children with quadriplegic CP , Gross Motor Function Classification System for Cerebral Palsy levels IV ( n = 9 ) and V ( n = 9 ) participated in the 12-week program . Subjects were assigned r and omly to one of two groups : therapeutic taping + physical therapy or physical therapy only . Therapeutic taping was applied for periods of up to 72 hours over the paraspinal region . The effects were assessed with the Gross Motor Function Measure ( GMFM-88 ) at baseline , six weeks , and 12 weeks . A factorial analysis of variance was used to examine group differences over time . Results : No significant differences were found for the GMFM-88 scores between groups over time . Conclusion : Therapeutic taping does not evoke a positive functional change in the seated postural control of children with quadriplegic cerebral palsy . Subjective observation , however , suggested that one child with athetosis benefited from therapeutic taping over the paraspinal region A recent r and omized controlled trial indicated that modified Constraint-Induced Movement Therapy followed by Bimanual Training ( mCIMT-BiT ) is an effective intervention to improve spontaneous use of the affected upper limb in children with unilateral spastic cerebral palsy ( CP ) . The present study aim ed to investigate how the above-mentioned improvements as a result of 8 weeks mCIMT-BiT were established . 52 children with unilateral spastic CP with Manual Ability Classification System ( MACS ) scores I , II or III and aged 2.5 - 8 years were r and omly allocated to either mCIMT-BiT ( n = 28 ) or Usual Care ( UC ) ( n = 24 ) . Developmental disregard ( ' learned non-use ' ) and upper limb capacity and performance scores were derived from the Video Observations Aarts and Aarts , module Determine Developmental Disregard . Active and passive range of motion at the affected wrist and elbow were assessed using goniometry during isolated movements . Upper limb capacity and performance demonstrated significantly greater improvements after mCIMT-BiT compared to UC , which lasted up to 8 weeks follow-up , whereas developmental disregard and passive and active range of motion did not show differential effects . The results support the notion that improvement of capacity and performance of the upper limb through mCIMT-BiT in children with unilateral spastic CP is based on a better utilization of existing motor functions of the affected arm and h and . However , enhancement of the overall amount of use ( or the reduction of learned non-use ) may still be suboptimal leaving room for improvement of this treatment AIM The aim of this study was to investigate the effects of Kinesio Taping ( KT ) on the body functions and activity of children with unilateral spastic cerebral palsy ( CP ) . METHOD This study was design ed as a single-blind , r and omized , controlled trial . Thirty children with unilateral spastic CP were r and omized and split equally between the  KT group ( eight males , seven females ; mean age 9y [ SD 2y 3mo ] range 7 - 12y ) and the control group ( seven males , eight females ; mean age 9y 7mo [ SD 3y 4mo ] range 7 - 14y ) receiving usual care . All participants were evaluated with the Functional Independence Measure for Children ( WeeFIM ) , the Bruininks-Oseretsky Test of Motor Proficiency ( BOTMP ) , the Gross Motor Function Measure ( GMFM ) , short-term muscle power , agility and functional muscle strength tests . Wilcoxon signed-rank and Mann-Whitney U tests were used to evaluate within and between-group differences respectively . The level of significance was accepted as p<0.05 . RESULTS There were significant differences in muscle power sprint ( p=0.003 ) , lateral step-up test right ( p=0.016 ) , sit to st and ( p=0.018 ) , attain st and through half knee right ( p=0.003 ) , BOTMP Gross scores ( p=0.019 ) , and WeeFIM total ( p=0.003 ) and self-care scores ( p=0.022 ) between the groups ( p<0.05 ) . INTERPRETATION Kinesio Taping is a promising additional approach to increase proprioceptive feedback and improve physical fitness , gross motor function , and activities of daily living in children with CP Cerebral palsy ( CP ) is a chronic nervous system disease that severely damages the physical and developmental health of children . Traditional treatment brings about only improvement of mild to moderate CP , but severe CP still lacks effective interventions . To explore safety and efficacy of using neural progenitor cells ( NPCs ) to treat CP in children , we performed NPC transplantation in 45 patients with severe CP by injecting NPCs derived from aborted fetal tissue into the lateral ventricle . Gross motor function measures ( GMFM ) , the Peabody Developmental Motor Scale-Fine Motor ( PDMS-FM ) test , and a unified survey question naire design ed specifically for children with CP were used to evaluate neurological function of the patients . Motor development was significantly accelerated within the first month after cell transplantation , but the rate of improvement gradually slowed to preoperative levels . However , after 1 year , the developmental level in each functional sphere ( gross motor , fine motor , and cognition ) of the treatment group was significantly higher compared to the control group . No delayed complications of this therapy were noted . These results suggest that NPC transplantation is a safe and effective therapeutic method for treating children with severe CP Cherng R-J , Liu C-F , Lau T-W , Hong R-B : Effect of treadmill training with body weight support on gait and gross motor function in children with spastic cerebral palsy . Am J Phys Med Rehabil 2007;86:548–555 . Objective : To examine the effect of treadmill training with body weight support ( TBWS ) on gait and gross motor function in children with spastic cerebral palsy ( CP ) . Design : Eight children with spastic CP participated in the study . Their temporal-distance gait parameters , Gross Motor Function Measure , muscle tone , and selective motor control were assessed three times : two times under their regular therapeutic treatment ( condition A ) , and one time after receiving the TBWS treatment in addition to their regular therapeutic treatments ( condition B ) . There were two treatment schedules , AAB and ABA . Except for the first one ( taken at study entry ) , the assessment s were always taken after 12 wks of treatment . The children were equally divided into two groups and r and omly assigned to the two schedules . The two groups were matched according to category of the Gross Motor Function Classification System . Results : The TBWS treatment significantly improved the children ’s gait ( increases in stride length and decreases in double-limb support percentage of gait cycle ) and their Gross Motor Function Measure ( dimension D and E scores as well as the total score ) . No significant improvements on muscle tone or selective motor control were noted . Conclusions : The TBWS treatment improved some gait parameters and gross motor functions in children with spastic CP
INTERPRETATION In children with CP , h and splints may have a small benefit for upper limb skills .
However , results are diminished after splint wearing stops .
AIM The aim of this review was to determine the effectiveness of h and splinting for improving h and function in children with cerebral palsy ( CP ) and brain injury .