Best responders after intensive upper-limb training for children with unilateral cerebral palsy
MetadataShow full item record
Objective: To delineate characteristics of best responders in a randomized trial comparing constraint-induced movement therapy (CIMT) to bimanual training for children with unilateral cerebral palsy. Design: Secondary analysis of a single-blind matched-pairs randomized comparison trial. Setting: Community sporting facilities in 2 Australian capital cities. Participants: Children (n=64; mean age, 10.2±2.7y; 52% boys), matched for age, sex, side of hemiplegia, and upper-limb function, were randomized within pairs to CIMT or bimanual training. Sixty-one children who completed CIMT (n=31) or bimanual training (n=30) were included in this study. Interventions: Each intervention was delivered in day camps (total 60h over 10d) using a novel circus theme with goal-directed training. Main Outcome Measures: Change between baseline, 3, and 26 weeks on the Melbourne Assessment of Unilateral Upper Limb Function (MUUL>7.4%), Assisting Hand Assessment (AHA>4 raw score points), and Canadian Occupational Performance Measure (COPM>2 points) defined best responders.Results: Poorer baseline hand function predicted a best response for unimanual capacity of the impaired upper limb (MUUL) immediately postintervention; however, at 26 weeks the odds of achieving a favorable outcome were 21 times greater for CIMT than bimanual training. A favorable response for bimanual performance (AHA) was predicted by immediate change in Jebsen-Taylor hand function test scores. Age (older), left-sided hemiplegia, and lower-baseline COPM performance scores significantly predicted favorable individualized outcomes. Conclusions: Secondary analysis of a randomized trial directly comparing 2 upper-limb training models, found children with poorer hand function benefited most. Favorable outcomes for bimanual performance were associated with gains in movement efficiency and older children with left-sided hemiplegia achieved more favorable gains in perceived occupational performance.
Showing items related by title, author, creator and subject.
Comparison of dosage of intensive upper limb therapy for children with unilateral cerebral palsy: How big should the therapy pill be?Sakzewski, L.; Provan, K.; Ziviani, J.; Boyd, Roslyn (2015)therapy (mCIMT) and bimanual therapy on upper limb and individualized outcomes for children with unilateral cerebral palsy. This secondary analysis included two separate randomized trials that compared equal doses (high ...
Randomized trial of constraint-induced movement therapy and bimanual training on activity outcomes for children with congenital hemiplegiaSakzewski, L.; Ziviani, J.; Abbott, D.; Macdonell, R.; Jackson, G.; Boyd, Roslyn (2011)Aim: To determine if constraint-induced movement therapy (CIMT) is more effective than bimanual training (BIM) in improving upper limb activity outcomes for children with congenital hemiplegia in a matched-pairs randomized ...
Participation outcomes in a randomized trial of 2 models of upper-limb rehabilitation for children with congenital hemiplegiaSakzewski, L.; Ziviani, J.; Abbott, D.; MacDonell, R.; Jackson, G.; Boyd, Roslyn (2011)Objective: To determine if constraint-induced movement therapy (CIMT) is more effective than bimanual training to improve occupational performance and participation in children with congenital hemiplegia. Design: Single-blind ...