taub - Efficacy of Constraint-Induced Movement Therapy for...

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DOI: 10.1542/peds.113.2.305 2004;113;305-312 Pediatrics Edward Taub, Sharon Landesman Ramey, Stephanie DeLuca and Karen Echols Palsy With Asymmetric Motor Impairment Efficacy of Constraint-Induced Movement Therapy for Children With Cerebral http://www.pediatrics.org/cgi/content/full/113/2/305 located on the World Wide Web at: The online version of this article, along with updated information and services, is rights reserved. Print ISSN: 0031-4005. Online ISSN: 1098-4275. Grove Village, Illinois, 60007. Copyright © 2004 by the American Academy of Pediatrics. All and trademarked by the American Academy of Pediatrics, 141 Northwest Point Boulevard, Elk publication, it has been published continuously since 1948. PEDIATRICS is owned, published, PEDIATRICS is the official journal of the American Academy of Pediatrics. A monthly . Provided by Purdue University Libraries on October 25, 2010 www.pediatrics.org Downloaded from
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Efficacy of Constraint-Induced Movement Therapy for Children With Cerebral Palsy With Asymmetric Motor Impairment Edward Taub, PhD*; Sharon Landesman Ramey, PhD‡§; Stephanie DeLuca, PhD*‡; and Karen Echols, PhD‡ ABSTRACT. Objective. Constraint-Induced Move- ment (CI) therapy has been found to be a promising treatment for substantially increasing the use of extrem- ities affected by such neurologic injuries as stroke and traumatic brain injury in adults. The purpose of this study was to determine the applicability of this interven- tion to young children with cerebral palsy. Methods. A randomized, controlled clinical trial of pediatric CI therapy in which 18 children with diagnosed hemiparesis associated with cerebral palsy (7–96 months old) were randomly assigned to receive either pediatric CI therapy or conventional treatment. Pediatric CI ther- apy involved promoting increased use of the more-af- fected arm and hand by intensive training (using shap- ing) of the more-impaired upper extremity for 6 hours/ day for 21 consecutive days coupled with bivalved casting of the child’s less-affected upper extremity for that period. Children’s functional upper-extremity skills were assessed in the laboratory (blinded scoring) and at home (parent ratings) just prior, after, and 3 weeks post- treatment. Treated children were followed for 6 months. Results. Children receiving pediatric CI therapy com- pared with controls acquired significantly more new classes of motoric skills (9.3 vs 2.2); demonstrated signif- icant gains in the mean amount (2.1 vs 0.1) and quality (1.7 vs 0.3) of more-affected arm use at home; and in a laboratory motor function test displayed substantial im- provement including increases in unprompted use of the more-affected upper extremity (52.1% vs 2.1% of items). Benefits were maintained over 6 months, with supple- mental evidence of quality-of-life changes for many chil- dren.
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taub - Efficacy of Constraint-Induced Movement Therapy for...

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