Effects of Forms of Modified CIT on Upper Extremity Performance in Cerebral Palsy

Study Overview
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Brief Summary
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The purpose of this study will employ clinical assessment tools to examine the effects of modified constraint-induced therapy (mCIT) on the more affected upper extremity of children with cerebral palsy.

Detailed Description
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The study included threefold: (1) It will employ kinematic analysis, along with clinical assessment tools to examine the effects of mCIT on the more affected upper extremity of children with cerebral palsy with asymmetric motor impairments after treatment immediately and 1 year following. The clinical tools will include Motor Activity Log (MAL), Bruininks-Oseretsky Test of Motor Proficiency (BOTMP),Peabody-Developmental Motor Scales (PDMS-II), and Wee-FIM. (2) This study looked at the intervention impact on bimanual coordination and the less affected upper extremity. (3) It investigated the effects of forms (group vs. individual intervention) on upper extremity performance.

Official Title
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Effects of Forms of Modified Constraint-induced Therapy on Functional Performance of Upper Extremity in Children With Cerebral Palsy With Asymmetric Motor Impairments: A Follow up Study of Kinematic and Clinical Analyses

Conditions
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Cerebral Palsy

Intervention / Treatment
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* Other: Hospital-based mCIT restraint of the unaffected arm and practice of the affected arm
* Other: Hospital-based mCIT
* Other: Hospital-based TR


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: clinical diagnosis of spastic CP age between 4 and 10 years old shoulder flexion of the affected upper limb more than 90 degrees, elbow extension over 160 degrees, wrist extension to 10 degrees at least, and fingers full flexion to 10 degrees at least basic balance ability: sitting on the chair without arm support; feet stay on the floor consistently; performing the affected upper limb movement without losing balance ability to follow simple oral commands no related musculoskeletal surgery of the affected upper limb not have injected the Botox into the affected upper extremity during the past 6 months no visual or auditory disability

Ages Eligible for Study
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Minimum Age: 4 Years
Maximum Age: 10 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Hospital-based mCIT with individualized intervention<br>Hospital-based modified constraint-induced therapy(mCIT) | Other: Hospital-based mCIT restraint of the unaffected arm and practice of the affected arm<br>* the mCIT group with individualized intervention<br>* Other names: Hospital-based modified constraint-induced therapy(mCIT);|
| Experimental: Hospital-based mCIT with group therapy<br>Hospital-based modified constraint-induced therapy(mCIT) | Other: Hospital-based mCIT<br>* the mCIT group with individualized intervention<br>* Other names: Hospital-based modified constraint-induced therapy(mCIT);|
| Other: Hospital-based TR<br>Hospital-based traditional rehabilitation (TR) | Other: Hospital-based TR<br>* OT or PT or therapist-based training<br>* Other names: Hospital-based traditional rehabilitation (TR);|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Kinematic assessment | An analysis program coded by LabVIEW (National Instruments, Inc., Austin, TX) language was used to process the kinematic data. The variables of reaction time (sec), normalized movement time (sec/mm), normalized total displacement (unit), joint ranges recruitment (normalized shoulder flexion angle, normalized elbow flexion; degree/mm) angle, and normalized maximum shoulder abduction angle), and maximum shoulder and elbow cross correlation were collected. | up to six years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Clinical measures at the motor quality and performance include Motor Activity Log (MAL), Bruininks-Oseretsky Test of Motor Proficiency (BOTMP), and Peabody-Developmental Motor Scales (PDMS-II) | The clinical tools used in this study measure the intervention impact on bimanual coordination and unilateral performance of upper extremity. | up to six years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Modified constraint-induced therapy, Children with cerebral palsy, Kinematic analysis, Group therapy