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Is outcome of constraint‐induced movement therapy in unilateral cerebral palsy dependent on corticomotor projection pattern and brain lesion characteristics?
Author(s) -
Islam Mominul,
Nordstrand Linda,
Holmström Linda,
Kits Annika,
Forssberg Hans,
Eliasson AnnChristin
Publication year - 2014
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.12353
Subject(s) - cerebral palsy , constraint induced movement therapy , lesion , physical medicine and rehabilitation , transcranial magnetic stimulation , psychology , magnetic resonance imaging , physical therapy , medicine , motor function , neuroscience , stimulation , surgery , radiology
Aim The aim of the study was to explore individual variations in outcome of hand function after constraint‐induced movement therapy ( CIMT ) in relation to the organization of corticomotor projection and brain lesion characteristics in participants with unilateral cerebral palsy ( CP ). Method Sixteen participants (eight males, eight females; mean age 13y, [ SD 2y] range 10–16y) with unilateral CP (nine right‐sided; Manual Ability Classification System [ MACS ] level I, n =1; level II, n =15) who participated in a 2‐week CIMT day camp (63h) were included in the study. Various aspects of hand function were measured by the Jebsen–Taylor Hand Function Test ( JTHFT ), the Assisting Hand Assessment ( AHA ), and the Melbourne Assessment, both before and after the day camp. Transcranial magnetic stimulation was used to explore the corticomotor organization, and brain lesion characteristics were described by visual assessment of conventional structural magnetic resonance images. Results At a group level, the training was associated with significant improvements in JTHFT ( p =0.003) and AHA ( p =0.046), but not in Melbourne Assessment scores. Improvements were found in all types of corticomotor projection patterns, i.e. contralateral, mixed, and ipsilateral. There was no relationship between functional improvement and brain lesion characteristics. Interpretation Individuals with CP experience improved motor outcomes after CIMT , independent of corticomotor projection pattern and lesion characteristics.