Methods of constraint-induced movement therapy for children with hemiplegic cerebral palsy: Development of a child-friendly intervention for improving upper-extremity function
Methods of constraint-induced movement therapy for children with hemiplegic cerebral palsy: Development of a child-friendly intervention for improving upper-extremity function
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DOI：
10.1016/j.apmr.2004.10.008
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发表时间：
2005-04-01
影响因子：
4.3
通讯作者：
Wolf, SL
中科院分区：
文献类型：
--
作者：
Gordon, AA;Charles, J;Wolf, SL
我们描述的方法，约束诱导运动疗法（CIMT）修改为偏瘫型脑瘫（CP）的儿童，并描述了重要的考虑因素，需要在儿童测试这种干预。由此产生的干预措施是在38名4至14岁的偏瘫CP儿童中进行试点和测试后发展而来的。37人成功完成治疗方案。干预措施保留了成人CIMT的2个主要要素（重复练习，塑造），并尽可能对儿童友好。它包括用吊带限制未受累肢体，并让儿童每天6小时（60小时）用受累肢体进行单手活动。通过考虑具有明显缺陷的关节运动来选择特定活动，并且干预者认为这些关节运动具有最大的潜力。活动的选择是为了引起重复的练习和塑造。干预以2至3名儿童为一组进行，以提供社会互动、示范和鼓励。每个孩子都被分配给一名干预人员，以保持至少1：1的比例。CIMT可以修改为儿童友好型，同时保持成人CIMT的所有实践元素。大多数儿童可以耐受改良疗法。在将干预措施应用于最有可能受益的儿童之前，可能需要进一步修改，以确定最有效的干预措施的具体组成部分。(c)2005年由美国康复医学大会和美国物理医学与康复学会
We delineate the methodology for constraint-induced movement therapy (CIMT) modified for children with hemiplegic cerebral palsy (CP) and describe important considerations that need to be made when testing this intervention in children. The resulting intervention evolved from piloting and testing it with 38 children with hemiplegic CP who were between the ages of 4 and 14 years. Thirty-seven successfully completed the treatment protocol. The intervention retains the 2 major elements of the adult CIMT (repetitive practice, shaping) and was constructed to be as child-friendly as possible. It involves restraining the noninvolved extremity with a sling and having the child engage in unimanual activities with the involved extremity 6 hours a day for 10 days (60h). Specific activities are selected by considering joint movements with pronounced deficits and improvement of which interventionists believe have greatest potential. The activities are chosen to elicit repetitive practice and shaping. The intervention is conducted in groups of 2 to 3 children to provide social interaction, modeling and encouragement. Each child is assigned to an interventionist to maintain at least a 1:1 ratio. CIMT can be modified to be child-friendly while maintaining all practice elements of the adult CIMT. The modified therapy is tolerated by most children. Further modifications will likely be required to hone in on the specific components of the intervention that are most effective before applying them to children who are most likely to benefit. (c) 2005 by American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation