scholarly journals Effects of combining constraint-induced movement therapy and action-observation training on upper limb kinematics in children with unilateral cerebral palsy: A randomized controlled trial

2019 ◽  
Author(s):  
Cristina Simon-Martinez ◽  
Lisa Mailleux ◽  
Ellen Jaspers ◽  
Els Ortibus ◽  
Kaat Desloovere ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Motor Control ◽  
Upper Limb ◽  
Peak Velocity ◽  
Action Observation ◽  
Movement Patterns ◽  
Movement Duration ◽  
Constraint Induced Movement Therapy ◽  
Unilateral Cerebral Palsy ◽  
Observation Training

AbstractModified constraint-induced movement therapy (mCIMT) improves upper limb (UL) motor execution in unilateral cerebral palsy (uCP). As these children also show motor planning deficits, action-observation training (AOT) might be of additional value. Here, we investigated the combined value of AOT to mCIMT on UL kinematics in children with uCP. Thirty-six children with uCP completed an UL kinematic evaluation after participating in a 9-day mCIMT camp wearing a splint for 6 hours/day. The experimental group (mCIMT+AOT, n=20) received 15 hours of AOT, i.e. video-observation and execution of unimanual tasks. The control group (mCIMT+placebo, n=16) watched biological-motion free videos and executed the same tasks. We examined changes in motor control (movement duration, peak velocity, time-to-peak velocity, and trajectory straightness) and movement patterns (using Statistical Parametric Mapping) during the execution of three unimanual, relevant tasks before the intervention, after and at 6 months follow-up. Adding AOT to mCIMT mainly affected movement duration during reaching, whereas little benefit is seen on UL movement patterns. mCIMT, with or without AOT, improved peak velocity and trajectory straightness, and proximal movement patterns. These results highlight the importance of including kinematics in an UL evaluation to capture changes in motor control and movement patterns of the proximal joints.

scholarly journals Randomized controlled trial combining constraint-induced movement therapy and action-observation training in unilateral cerebral palsy: clinical effects and influencing factors of treatment response

2019 ◽  
Author(s):  
Cristina Simon-Martinez ◽  
Lisa Mailleux ◽  
Jasmine Hoskens ◽  
Els Ortibus ◽  
Ellen Jaspers ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Treatment Response ◽  
Influencing Factors ◽  
Action Observation ◽  
Sensory Function ◽  
Constraint Induced Movement Therapy ◽  
Bimanual Performance ◽  
Unilateral Cerebral Palsy ◽  
Observation Training

AbstractIntroductionConstraint-induced movement therapy (CIMT) improves upper limb (UL) motor execution in unilateral cerebral palsy (uCP). As these children also show motor planning deficits, action-observation training (AOT) might be of additional value. Here, we investigated the combined effect of AOT to CIMT and identified factors influencing treatment response.MethodsForty-four children with uCP (mean 9y6m, SD 1y10m) participated in a 9-day camp wearing a splint for 6 hours/day and were allocated to the CIMT+AOT (n=22) and the CIMT+placebo group (n=22). The CIMT+AOT group received 15 hours of AOT (i.e. video-observation) and executed the observed tasks, whilst the CIMT+AOT group watched videos free of biological motion and executed the same tasks. The primary outcome measure was bimanual performance. Secondary outcomes included measures at body function and activity level assessed before (T1), after (T2) the intervention, and at 6 months follow-up (T3). Influencing factors included behavioural and neurological characteristics.ResultsAlthough no between-groups differences were found (p>0.05), the addition of AOT led to higher gains in children with initially poorer bimanual performance (p=0.02). Both groups improved in all outcome measures after the intervention and retained the gains at follow up (p<0.01). Poor sensory function resulted in larger improvements in the total group (p=0.03) and high amount of mirror movements tended to result in better response to the additional AOT training (p=0.06). Improvements were similar irrespective of the type of brain lesion or corticospinal tract wiring pattern.ConclusionsAdding AOT to CIMT, resulted in better outcome for children with poor motor function and high amount of mirror movements. CIMT with or without AOT seems to be more beneficial for children with poor sensory function.Trial registrationRegistered at ClinicalTrials.gov on 22nd August 2017 (Identifier: NCT03256357).

scholarly journals Randomized controlled trial combining constraint-induced movement therapy and action-observation training in unilateral cerebral palsy: clinical effects and influencing factors of treatment response

2020 ◽  
Vol 13 ◽  
pp. 175628641989806 ◽  
Author(s):  
Cristina Simon-Martinez ◽  
Lisa Mailleux ◽  
Jasmine Hoskens ◽  
Els Ortibus ◽  
Ellen Jaspers ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Treatment Response ◽  
Influencing Factors ◽  
Action Observation ◽  
Sensory Function ◽  
Constraint Induced Movement Therapy ◽  
Bimanual Performance ◽  
Unilateral Cerebral Palsy ◽  
Observation Training

Introduction: Constraint-induced movement therapy (CIMT) improves upper limb (UL) motor execution in unilateral cerebral palsy (uCP). As these children also show motor planning deficits, action-observation training (AOT) might be of additional value. Here, we investigated the combined effect of AOT to CIMT and identified factors influencing treatment response. Methods: A total of 44 children with uCP (mean 9 years 6 months, SD 1 year 10 months) participated in a 9-day camp wearing a splint for 6 h/day and were allocated to the CIMT + AOT ( n = 22) and the CIMT + placebo group ( n = 22). The CIMT + AOT group received 15 h of AOT (i.e. video-observation) and executed the observed tasks, whilst the CIMT + AOT group watched videos free of biological motion and executed the same tasks. The primary outcome measure was bimanual performance. Secondary outcomes included measures of body function and activity level assessed before (T1), after the intervention (T2), and at 6 months follow-up (T3). Influencing factors included behavioural and neurological characteristics. Results: Although no between-groups differences were found ( p > 0.05; η2 = 0–16), the addition of AOT led to higher gains in children with initially poorer bimanual performance ( p = 0.02; η2 = 0.14). Both groups improved in all outcome measures after the intervention and retained the gains at follow up ( p < 0.01; η2 = 0.02–0.71). Poor sensory function resulted in larger improvements in the total group ( p = 0.03; η2 = 0.25) and high amounts of mirror movements tended to result in a better response to the additional AOT training ( p = 0.06; η2 = 0.18). Improvements were similar irrespective of the type of brain lesion or corticospinal tract wiring pattern. Conclusions: Adding AOT to CIMT, resulted in a better outcome for children with poor motor function and high amounts of mirror movements. CIMT with or without AOT seems to be more beneficial for children with poor sensory function. Trial registration: Registered at ClinicalTrials.gov on 22nd August 2017 (ClinicalTrials.gov identifier: NCT03256357).

P96: Muscle weakness impacts negatively upper limb movement patterns in children with unilateral cerebral palsy

2017 ◽  
Vol 57 ◽  
pp. 333
Author(s):  
Cristina Simon-Martinez ◽  
Eirini Papageorgiou ◽  
Ellen Jaspers ◽  
Lisa Mailleux ◽  
Kaat Desloovere ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Muscle Weakness ◽  
Upper Limb ◽  
Movement Patterns ◽  
Limb Movement ◽  
Unilateral Cerebral Palsy
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