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Younger Children with Cerebral Palsy Respond Better Than Older Ones to Therapist-Based Constraint-Induced Therapy at Home on Functional Outcomes and Motor Control
Authors:Hsieh-ching Chen  Lin-ju Kang  Keh-chung Lin  Fei-chuan Chen  Katie P.H. Wu
Affiliation:1. Department of Industrial Engineering &2. Management, National Taipei University of Technology, Taipei, Taiwan;3. Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Taoyuan, Taiwan;4. School of Occupational Therapy, College of Medicine, National Taiwan University and Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan;5. Buddhist Tzu Chi General Hospital, Xindian, New Taipei City, Taiwan;6. Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan;7. Department of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
Abstract:Aims: To examine the differences in efficacy of home-based constraint-induced therapy (CIT) on functional outcomes and motor control in two age groups of children with cerebral palsy (CP). Methods: Twenty-three children with spastic unilateral CP receiving 4-week home-based CIT by a therapist were divided into younger (6–8 years; n = 11) and older (9–12 years; n = 12) groups. The home-based CIT involved intensive functional training of the more affected upper-limb while restraining the less affected upper-limb. The outcome measures were Peabody Developmental Motor Scale-2nd edition (PDMS-2) that was being used in a modified way, Functional Independence Measure for Children (WeeFIM), and reach-to-grasp kinematic parameters, including reaction time (RT), normalized movement time (MT), normalized movement units (MUs), peak velocity (PV), and maximum grip aperture (MGA). The outcome measures were assessed at baseline, 4-weeks (post-treatment), 3- and 6-months (follow-up). Results: The younger group showed greater changes in visual motor integration skills and RT at all post-tests after intervention than the older group. Groups had comparable changes on any other measures. Conclusions: Younger children with CP responded better to home-based CIT on some areas of upper-limb functions and reach-to-grasp motor control strategies than older children.
Keywords:Age  cerebral palsy  constraint-induced therapy  functional outcomes  motor control
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