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 .
Remodeling the Brain: Plastic Structural Brain Changes Produced by Different Motor Therapies After Stroke
Background and Purpose — Studies on adult stroke patients have demonstrated functional changes in cortical excitability , metabolic rate , or blood flow after motor therapy , measures that can fluctuate rapidly over time . This study evaluated whether evidence could also be found for structural brain changes during an efficacious rehabilitation program . Methods — Chronic stroke patients were r and omly assigned to receive either constraint-induced movement therapy ( n=16 ) or a comparison therapy ( n=20 ) . Longitudinal voxel-based morphometry was performed on structural MRI scans obtained immediately before and after patients received therapy . Results — The group receiving constraint-induced movement therapy exhibited far greater improvement in use of the more affected arm in the life situation than the comparison therapy group . Structural brain changes paralleled these improvements in spontaneous use of the more impaired arm for activities of daily living . There were profuse increases in gray matter in sensory and motor areas both contralateral and ipsilateral to the affected arm that were bilaterally symmetrical , as well as bilaterally in the hippocampus . In contrast , the comparison therapy group failed to show gray matter increases . Importantly , the magnitude of the observed gray matter increases was significantly correlated with amount of improvement in real-world arm use . Conclusions — These findings suggest that a previously overlooked type of brain plasticity , structural remodeling of the human brain , is harnessed by constraint-induced movement therapy for a condition once thought to be refractory to treatment : motor deficit in chronic stroke patients
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 .