到宅式修正侷限誘發運動療法應用於痙攣型腦性麻痺兒童之療效：初步研究

Effects of Home-based Modified Constraint-induced Movement Therapy in Children with Spastic Cerebral Palsy: A Preliminary Study

陳斐娟(Fei-Chuan Chen) ； 吳菁宜(Ching-Yi Wu) ； 陳協慶(Hsieh-Ching Chen) ； 林克忠(Keh-Chung Lin) ； 鍾佳英(Chia-Ying Chung) ； 陳嘉玲(Chia-Ling Chen)

《台灣復健醫學雜誌》 39卷2期 (2011/06) Pp. 85-93

https://doi.org/10.6315/2011.39(2)03

摘要

Previous studies have shown beneficial effects of modified constraint-induced movement therapy (mCIMT) in improving motor functions of the upper extremities in children with spastic cerebral palsy (CP). However, there are few studies which have used kinematic analysis to validate the effectiveness and mechanisms underlying motor improvement after mCIMT. To promote clinical applicability and children's compliance with mCIMT, this study attempted to investigate the effects of home-based mCIMT in children with spastic CP using integration of clinical measures and kinematic analysis.
This study used a randomized controlled trial design. Twelve children with spastic CP (6 boys and 6 girls) were randomly assigned to mCIMT and traditional rehabilitation (TR) groups. Both groups received 4 weeks of home-based interventions with either mCIMT or TR (twice per week for 4 hours for each intervention). Clinical measures and kinematic parameters were analyzed in all children before and after the intervention. Clinical measures included the amount and quality of affected limb usage, and grasp and visual motor integration (VMI) functions. Kinematic parameters included reaction time (RT), movement time (MT), movement units (MU), and peak velocity (PV). The effectiveness index (EI) for clinical measures and kinematic parameters was calculated as follows: 100%×(post-test score-pre-test score)/pre-test-score.
Our results showed there were no significant differences in the baseline data and severity between the two groups. The EIs for the amount and quality of affected limb usage, and grasp functions were better in the mCIMT group than the TR group (p＜0.05). The EIs for the RT, MT and MU in the mCIMT group were significantly better than in the TR group (p＜0.05). However, the EIs for the VMI functions and PV showed no significant differences between groups.
Our findings suggest that home-based mCIMT intervention can enhance motor planning, movement efficiency and smoothness to improve upper limb usage and motor function by increasing the motivation and participation of these children.

關鍵字

修正式侷限誘發運動療法 ； 腦性麻痺 ； 動作功能 ； 運動學分析 ； 到宅服務

並列摘要

Previous studies have shown beneficial effects of modified constraint-induced movement therapy (mCIMT) in improving motor functions of the upper extremities in children with spastic cerebral palsy (CP). However, there are few studies which have used kinematic analysis to validate the effectiveness and mechanisms underlying motor improvement after mCIMT. To promote clinical applicability and children's compliance with mCIMT, this study attempted to investigate the effects of home-based mCIMT in children with spastic CP using integration of clinical measures and kinematic analysis.
This study used a randomized controlled trial design. Twelve children with spastic CP (6 boys and 6 girls) were randomly assigned to mCIMT and traditional rehabilitation (TR) groups. Both groups received 4 weeks of home-based interventions with either mCIMT or TR (twice per week for 4 hours for each intervention). Clinical measures and kinematic parameters were analyzed in all children before and after the intervention. Clinical measures included the amount and quality of affected limb usage, and grasp and visual motor integration (VMI) functions. Kinematic parameters included reaction time (RT), movement time (MT), movement units (MU), and peak velocity (PV). The effectiveness index (EI) for clinical measures and kinematic parameters was calculated as follows: 100%×(post-test score-pre-test score)/pre-test-score.
Our results showed there were no significant differences in the baseline data and severity between the two groups. The EIs for the amount and quality of affected limb usage, and grasp functions were better in the mCIMT group than the TR group (p＜0.05). The EIs for the RT, MT and MU in the mCIMT group were significantly better than in the TR group (p＜0.05). However, the EIs for the VMI functions and PV showed no significant differences between groups.
Our findings suggest that home-based mCIMT intervention can enhance motor planning, movement efficiency and smoothness to improve upper limb usage and motor function by increasing the motivation and participation of these children.

並列關鍵字

modified constraint-induced movement therapy ； cerebral palsy ； motor function ； kinematic analysis ； home-based services