Efficacy of Modified Constraint-induced Movement Therapy in Children With Brain Damage

Study Overview
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Brief Summary
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This research centers on the comparison of the immediate efficacy (right after therapy) and the maintained efficacy (3 months and 6 months) between Modified Constraint-Induced Movement Therapy (mCIMT) group and control group at different age.

Detailed Description
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Modified Constraint-Induced Movement Therapy is one of the most recent treatments for children with Brain damage. This well-designed and follow-up RCT study compared home-based CIT with a control intervention (traditional rehabilitation, TR) by combining kinematic analysis and clinical evaluation, which is possible to examine whether functional improvement is accompanied by a change in motor control. We hypothesized that home-based CIT would induce better motor control strategies (shorter RT, MT, lesser MUs, MGA, and PMGA, and larger peak velocity (PV)) for greater functional gains than TR. Furthermore, the beneficial effects would be maintained at 3 and 6 months of follow-up. Findings of this study allow clinicians to understand the underlying motor control changes for functional improvement after home-based CIT.

Official Title
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Efficacy of Modified Constraint-induced Movement Therapy in Children With Brain Damage: Evidence of Kinematic Study

Conditions
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Brain Damage, Cerebral Palsy, Traumatic Brain Damage

Intervention / Treatment
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* Behavioral: Modified Constraint-induced Movement Therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Development learned-nonuse Age range 4y/o-15y/o Wrist ext 10˚, MP j't ext 10˚ in affected U/E Can fallow up the simple instruction Modified Ashworth Scale ≦2 Pediatric Motor Activity Log ≦2.5 (average) Exclusion Criteria: Related muscle skeleton surgery Selective dorsal rhizotomy Botulinum toxin in 6 months Visual perception impaired Hearing perception impaired Balance ability impaired (in constrained)

Ages Eligible for Study
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Minimum Age: 4 Years
Maximum Age: 15 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: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Constraint-induced Movement Therapy<br> | Behavioral: Modified Constraint-induced Movement Therapy<br>* Home based CIT Restriction of the less affected limb Intensive practice using affected limb Positive experience Functional task (task)<br>* Other names: Immobilization Therapy;|
| Other: Transditional rehabilitation<br> | Behavioral: Modified Constraint-induced Movement Therapy<br>* Home based CIT Restriction of the less affected limb Intensive practice using affected limb Positive experience Functional task (task)<br>* Other names: Immobilization Therapy;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) | All children underwent a series of upper limb assessments, including kinematic analysis and functional measures (primary and secondary outcomes), before the start of the intervention (pretreatment). An occupational therapist blinded to group assignment was trained to administer these measures. All participants underwent these assessments at 4 weeks immediately after intervention (post-treatment), and at 12-week follow-up and 24-week follow-up. | 4 weeks (post-treatment), 12 week, 24 week | 
| Peabody Development Motor Scales, subtest fine motor (PDMS-Ⅱ) |  | 4 weeks (post-treatment), 12 week, 24 week | 
| Kinematic analysis |  | 4 weeks (post-treatment), 12 week, 24 week | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pediatric Motor Activity Log ( PMAL ) | All children underwent a series of upper limb assessments, including kinematic analysis and functional measures (primary and secondary outcomes), before the start of the intervention (pretreatment). An occupational therapist blinded to group assignment was trained to administer these measures. All participants underwent these assessments at 4 weeks immediately after intervention (post-treatment), and at 12-week follow-up and 24-week follow-up. | 4 weeks (post-treatment), 12 week, 24 week | 
| Pediatric Functional Independence Measure ( WeeFIM ) |  | 4 weeks (post-treatment), 12 week, 24 week | 
| Cerebral palsy quality of life (CPQoL) |  | 4 weeks (post-treatment), 12 week, 24 week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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brain damage, constraint induced movement therapy, kinematic, function, outcome, Quality of life