Diffusion Tensor Imaging Study of the Response to Constraint-Induced Movement Therapy of Children With Hemiparetic Cerebral Palsy and Adults With Chronic Stroke

Rickards, Tyler; Sterling, Chelsey; Taub, Edward; Perkins-Hu, Christi; Gauthier, Lynne; Graham, M. J.; Griffin, Angi; Davis, Drew; Mark, Victor W.; Uswatte, Gitendra

doi:10.1016/j.apmr.2013.08.245

Cited by 39 publications

(43 citation statements)

References 53 publications

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“…The authors observed a significant association between fractional anisotropy values of the corticospinal tract and pretreatment spinal motor function, with similar findings in relation to the PMAL-R. Patients with more lesions in the corticospinal path (resulting in disruption or dysplasia) showed worse results on the pretreatment PMAL-R compared with patients without lesions, indicating that the PMAL-R was sensitive enough to identify a clinical alteration that correlated with structural change 19 . Also in 2013, Sterling et al conducted a piece of research that aimed to compare demonstrated gains in motor and Table 2.…”

Section: Discussionsupporting

confidence: 58%

Translation and cross cultural adaptation of the Pediatric Motor Activity Log-Revised scale

Matuti

Santos

Silva

et al. 2016

Arq. Neuro-Psiquiatr.

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Cerebral palsy (CP) describes a group of disorders of movement and posture that are attributed to a non-progressive disorder in the immature brain and often limit functional activities 1 . Children with spastic hemiplegia, which is one type of CP, can experience difficulty in using the affected upper limb (AUL) -the limb contralateral to the lesion -because of poor selective motor control, muscle weakness, a stereotyped posture, and sensory deficits. These difficulties make attempts to use the AUL less frequent, and favor compensatory strategies in which the unaffected limb is used to perform functional activities. This can culminate in a cycle that results in decreased cortical representation of the affected segment because of disuse, thus developing the phenomenon known as "learned nonuse" 2 .Traditionally, the functionality of the AUL has been evaluated by observing motor performance during tests conducted in the clinic. However, the use of the AUL in this context often fails to reflect how the child actually performs in the real world 3,4 . The relationship between performance assessed by tests in the clinic environment and the spontaneous use of the AUL outside the therapeutic setting has not been established. Clinic-based tests do not take into consideration the phenomenon of learned nonuse, and therefore the effects of rehabilitation on everyday function are not properly evaluated 3,4 . A standardized instrument developed specifically to evaluate the function and spontaneous use of the AUL in children aged 2-8 years with CP is the Pediatric Motor Activity Log AbsTRACTThe standardized instrument developed to assess the use of the affected upper limb in children with cerebral palsy (CP) is the Pediatric Motor Activity Log Revised (PMAL-R). Objectives: To translate PMAL-R and adapt for the Brazilian culture; analyze the reliability and the internal consistency of the Brazilian version. Method: Translation of PMAL-R to the Portuguese-Brazil and back translation. The back-translated version was revised by the authors of the scale. The final version was administered to a sample of 24 patients with spastic hemiparesis CP between 2-8 years. Results: The reliability intra and inter-rater were suitable (how often = 0.97 and 0.98, how well = 0.98 and 0.99 respectively) and so the internal consistency (0.98). Conclusion: The Brazilian version of PMAL-R has adequate internal consistency, reliability intra and inter raters and can be used to assess the spontaneous use of the upper limb of children with CP type spastic hemiparesis, aged 2-8 years.Keywords: cerebral palsy; upper extremity; activities of daily living; evaluation. ResuMoA Pediatric Motor Activity Log-Revised (PMAL-R) é um instrumento padronizado desenvolvido para avaliar o uso do membro superior afetado em crianças com paralisia cerebral (PC). Objetivos: Traduzir a PMAL-R e fazer sua adaptação transcultural para o Português do Brasil; analisar a confiabilidade e a consistência interna da versão brasileira. Métodos: Tradução e retrotradução da PMAL-R. A ve...

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Section: Discussionsupporting

confidence: 58%

Translation and cross cultural adaptation of the Pediatric Motor Activity Log-Revised scale

Matuti

Santos

Silva

et al. 2016

Arq. Neuro-Psiquiatr.

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“…19 Diffusion analysis of the corticospinal tract has also revealed a relationship between the fractional anisotropy of the tract and a positive clinical change in adults with hemiplegia secondary to an acquired stroke 20 ; however, several recent reports in children have not associated corticospinal tract organization and integrity with the ability to benefit from constraint-induced movement therapy. 21,22 In this study, we investigate baseline neuroimaging characteristics related to clinical improvements following constraint therapy in children with congenital hemiplegic cerebral palsy using resting state functional MRI and diffusion tensor imaging. We compare the clinical changes with baseline MRI data to determine potential neuroimaging predictors of improved arm functionality after constraint therapy.…”

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confidence: 99%

Resting State and Diffusion Neuroimaging Predictors of Clinical Improvements Following Constraint-Induced Movement Therapy in Children With Hemiplegic Cerebral Palsy

et al. 2015

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The aim was to identify neuroimaging predictors of clinical improvements following constraint-induced movement therapy. Resting state functional magnetic resonance and diffusion tensor imaging data was acquired in 7 children with hemiplegic cerebral palsy. Clinical and magnetic resonance imaging (MRI) data were acquired at baseline and 1 month later following a 3-week constraint therapy regimen. A more negative baseline laterality index characterizing an atypical unilateral sensorimotor resting state network significantly correlated with an improvement in the Canadian Occupational Performance Measure score (r ¼-0.81, P ¼ .03). A more unilateral network with decreased activity in the affected hemisphere was associated with greater improvements in clinical scores. Higher mean diffusivity in the posterior limb of the internal capsule of the affect tract correlated significantly with improvements in the Jebsen-Taylor score (r ¼-0.83, P ¼ .02). Children with more compromised networks and tracts improved the most following constraint therapy.

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“…The literature demonstrates that the technique is effective for reversing of learned nonuse through plastic changes, demonstrated in changes in brain structure, accompanied by improved motor function and use of AUL in everyday activities, both in adult patients with acquired brain lesions, as in children and adolescents with CP 11,16 . The present study demonstrated that the original protocol of CIMT was adequate to reverse the learned nonuse of AUL in adult patients with CP.…”

Section: Discussionmentioning

confidence: 99%

“…Studies that compare the results of the technique through imaging exams (diffusion imaging) in children with CP and adults with Stroke, found that in children the same changes occur in the gray matter in the motor areas of the brain and hippocampus found in adults, leading to an improvement of motor function of the affected upper limb 11,16 . It is known that brain plasticity is higher in young children because the central nervous system is still in early phases of development.…”

Section: Discussionmentioning

confidence: 99%

“…The CIT protocol was then modified for children with CP, with some differences, such as the duration (3 hours/day for 15 days) and restriction with plaster, in which data proving the effectiveness of the technique were found in this population 11,16 . However, the use of pediatric protocol cannot be done with an adult population, as the study in question, since people are functionally engaged in activities that do not allow the limitation of UL unaffected by a period as long as the pediatric protocol (work, travel and study).…”

Section: Discussionmentioning

confidence: 99%

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Cerebral palsy in adult patients: constraint-induced movement therapy is effective to reverse the nonuse of the affected upper limb

Oliveira

Freitas

Garcia

et al. 2015

Arq. Neuro-Psiquiatr.

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Objective To determine if the original protocol of Constraint-Induced Movement Therapy (CIMT), is adequate to reverse the nonuse of the affected upper limb (AUL) in patients with Cerebral Palsy (CP) in adulthood. Method The study included 10 patients diagnosed with CP hemiparesis had attended the adult protocol CIMT, from January/August 2009/2014. Results Average age 24.6 (SD 9.44); MAL average pretreatment How Often (HO) = 0.72 and How Well (HW) = 0.68 and post-treatment HO = 3.77 and HW = 3.60 (p ≤ 0.001) and pretreatment WMFT average = 21.03 and post-treatment average = 18.91 (p = 0.350). Conclusion The constraint-induced movement therapy is effective to reverse the nonuse learn of the AUL in adult patients with CP.

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Diffusion Tensor Imaging Study of the Response to Constraint-Induced Movement Therapy of Children With Hemiparetic Cerebral Palsy and Adults With Chronic Stroke

Cited by 39 publications

References 53 publications

Translation and cross cultural adaptation of the Pediatric Motor Activity Log-Revised scale

Translation and cross cultural adaptation of the Pediatric Motor Activity Log-Revised scale

Resting State and Diffusion Neuroimaging Predictors of Clinical Improvements Following Constraint-Induced Movement Therapy in Children With Hemiplegic Cerebral Palsy

Cerebral palsy in adult patients: constraint-induced movement therapy is effective to reverse the nonuse of the affected upper limb

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