The Influence of Intense Combined Training on Upper Extremity Function in Children With Unilateral Cerebral Palsy: Does Initial Ability Matter?
The Influence of Intense Combined Training on Upper Extremity Function in Children With Unilateral Cerebral Palsy: Does Initial Ability Matter?
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DOI：
10.3109/01942638.2015.1108379
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发表时间：
2016-11-01
影响因子：
2.1
通讯作者：
Katz-Leurer, Michal
中科院分区：
文献类型：
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作者：
Cohen-Holzer, Marilyn;Sorek, Gilad;Katz-Leurer, Michal
目的：目的：探讨单侧脑性瘫痪（UCP）患儿的手功能水平是否会改变其对改良约束和双手训练相结合的强化训练的反应。研究方法：34名年龄在6- 11岁的儿童，手能力分类系统（MACS）I-III级（I：8，II：15，III：11），参加了为期2周的计划，每天结合一个小时的改进约束和5小时的双手练习。在干预前、干预后和干预后3个月进行辅助手评估（AHA）和Jebsen-Taylor手功能测试（JTTHF）。结果：平均AHA logits单位评分随时间增加（F-2;50 = 5，p = 0.01）。MACS水平之间的AHA logits单位变化评分无显著差异（F-4;56 = 1.4，p = 0.22）。JTTHF评分在受累或受累较少的手均未发生变化，尽管在受累较少的一侧发现时间和MACS水平的显著相互作用（F-4;58 = 6.5，p < 0.01）。与随着时间的推移表现出显著更大变化的MACS III级儿童相比，MACS I级和II级儿童的改善程度相似。结论：虽然在所有MACS水平的儿童的双手能力中发现了类似的改善趋势，但只有MACS III级的儿童在干预后受影响较小的一侧的单侧能力有所改善。
Aim: To examine whether level of manual ability modifies the response to an intensive program combining modified constraint and bimanual training on arm functioning children with unilateral cerebral palsy (UCP). Methods: Thirty-four children aged 6-11years, with Manual Ability Classification System (MACS) levels I-III (I:8, II:15, III:11), participated in a 2-week program, combining an hour of modified constraint with 5 hr of bimanual practice daily. The Assisting Hand Assessment (AHA) and the Jebsen-Taylor Test of Hand Function (JTTHF) were done pre-, post-, and 3-months post-intervention. Results: Mean AHA logits unit scores increased overtime (F-2;50 = 5, p = 0.01). There was no significant difference in AHA logits units change score between MACS levels (F-4;56 = 1.4, p = 0.22). JTTHF scores did not change for either the affected or less-affected hand, although a significant interaction of time and MACS level was found in the less-affected side (F-4;58 = 6.5, p < 0.01). Children in MACS levels I and II improved by similar degrees, in comparison to children at MACS level III who demonstrated significantly greater change over time. Conclusion: While a similar trend of improvement was found in the bimanual abilities of children at all MACS levels, only children at MACS level III had improved performance in unilateral abilities in the less-affected side following intervention.