Improvements in bimanual hand function after baby-CIMT in two-year old children with unilateral cerebral palsy: A retrospective study

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Section: Discussionmentioning

confidence: 99%

Longitudinal development of hand function in children with unilateral spastic cerebral palsy aged 18 months to 12 years

Nordstrand

Eliasson

Holmefur

2016

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“…Thirty‐six infants received constraint‐induced movement therapy, which involved 30 hours to 40 hours of specific hand training performed during the first year of life . Seventeen of them were included from a retrospective study, and 19 from a randomized controlled trial of constraint‐induced movement therapy/infant‐massage . Infants from Utrecht ( n =5) received erythropoietin treatment at birth …”

Section: Methodsmentioning

confidence: 99%

Development of hand function during the first year of life in children with unilateral cerebral palsy

Sakzewski

Sicola

Verhage

et al. 2018

Aim To identify developmental trajectories of hand function in infants aged 3 months to 12 months with unilateral cerebral palsy (CP). Method Infants at high risk of unilateral CP were recruited from 3 months of age from follow‐up programmes and clinics in Sweden, the Netherlands, Italy, and Australia. Measurements on the Hand Assessment for Infants (HAI) were completed until 12 months of age. Group‐based trajectory modelling was used to identify subgroups of infants with similar trajectories of development. Multinomial logistic regression determined associations between demographic variables and trajectory membership. Results Ninety‐seven infants (52 males, 45 females; median gestational age 38wks [interquartile range 30–40wks]) were included. Infants were assessed between two and seven times (mean 4, SD 1.2) with a total of 387 observations. A three‐group trajectory model identified a ‘low‐functioning group’ (n=45: 46%), ‘moderate‐functioning group’ (n=30: 31%), and ‘high‐functioning group’ (n=22: 23%). Mean posterior probabilities (0.91–0.96) and odds of correct classification (26.3–33.2) indicated good model fit. Type of brain lesion, sex, side of hemiplegia, country, gestational age, and access to intensive intervention were not associated with group membership. Interpretation Three trajectories of hand function development for infants with unilateral CP were identified and indicate some greater distinctions between groups with increasing age. The HAI is a valuable measure, capturing development of hand function of infants with unilateral CP over time. What this paper adds Three distinct developmental trajectories of hand function in infants with unilateral cerebral palsy were identified. A low‐functioning group made little progress in development of hand function in the first year of life. The degree of impairment on the impaired hand at 6 months of age is highly associated with trajectory membership. Infants with all types of brain lesion were represented across each trajectory group.

“…There was a total of 130 participants, ranging in age from 5 to 24 months. The most common intervention, used in five studies, was constraint-induced movement therapy (CIMT), 37,38,[42][43][44] followed by three studies that used NDT, 41,47,48 one that used the Vojta approach, 40 one treadmill training, 46 one mobility training, 45 one a developmental programme, 39 and one intensive 'physiotherapy' defined as an eclectic mix of concepts. 49 All studies reported positive results (Table SII), with the exception of Kinghorn and Roberts, 41 but causal inferences in these cases must be treated with caution because of the lack of comparison with a control, lack of statistical analysis in some studies, and the lack of rigorous measurement tools in many studies to document outcomes.…”

Section: Level IV and V Included Studiesmentioning

confidence: 99%

Effectiveness of motor interventions in infants with cerebral palsy: a systematic review

Morgan

Darrah

Gordon

et al. 2016

293

206

Aim To systematically review the evidence on the effectiveness of motor interventions for infants from birth to 2 years with a diagnosis of cerebral palsy or at high risk of it. Method Relevant literature was identified by searching journal article databases (PubMed, Embase, CINAHL, Cochrane, Web of Knowledge, and PEDro). Selection criteria included infants between the ages of birth and 2 years diagnosed with, or at risk of, cerebral palsy who received early motor intervention. Results Thirty‐four studies met the inclusion criteria, including 10 randomized controlled trials. Studies varied in quality, interventions, and participant inclusion criteria. Neurodevelopmental therapy was the most common intervention investigated either as the experimental or control assignment. The two interventions that had a moderate to large effect on motor outcomes (Cohen's effect size>0.7) had the common themes of child‐initiated movement, environment modification/enrichment, and task‐specific training. Interpretation The published evidence for early motor intervention is limited by the lack of high‐quality trials. There is some promising evidence that early intervention incorporating child‐initiated movement (based on motor‐learning principles and task specificity), parental education, and environment modification have a positive effect on motor development. Further research is crucial.