Motor learning curve and long-term effectiveness of modified constraint-induced movement therapy in children with unilateral cerebral palsy: A randomized controlled trial

Geerdink, Yvonne; Aarts, Pauline; Geurts, Alexander C. H.

doi:10.1016/j.ridd.2012.11.011

Cited by 41 publications

(67 citation statements)

References 27 publications

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“…Indeed, for a TMS to be a truly effective treatment, its effects should persist beyond the duration of treatment. Other studies have demonstrated that the effects of motor practice are retained for several months both in normal persons (Kleim and Jones, 2008; Pendt et al, 2011) and in patients with Parkinson's disease (Pendt et al, 2011), and cerebral palsy (Geerdink et al, 2013). While concomitant 5 Hz TMS to the premotor cortex during motor learning resulted in greater retention (Boyd and Linsdell, 2009), tDCS did not enhance long-term retention in healthy persons (Reis et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

Concurrent TMS to the primary motor cortex augments slow motor learning

et al. 2014

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Transcranial magnetic stimulation (TMS) has shown promise as a treatment tool, with one FDA approved use. While TMS alone is able to up- (or down-) regulate a targeted neural system, we argue that TMS applied as an adjuvant is more effective for repetitive physical, behavioral and cognitive therapies, that is, therapies which are designed to alter the network properties of neural systems through Hebbian learning. We tested this hypothesis in the context of a slow motor learning paradigm. Healthy right-handed individuals were assigned to receive 5 Hz TMS (TMS group) or sham TMS (sham group) to the right primary motor cortex (M1) as they performed daily motor practice of a digit sequence task with their non-dominant hand for 4 weeks. Resting cerebral blood flow (CBF) was measured by normalH215O PET at baseline and after 4 weeks of practice. Sequence performance was measured daily as the number of correct sequences performed, and modeled using a hyperbolic function. Sequence performance increased significantly at 4 weeks relative to baseline in both groups. The TMS group had a significant additional improvement in performance, specifically, in the rate of skill acquisition. In both groups, an improvement in sequence timing and transfer of skills to non-trained motor domains was also found. Compared to the sham group, the TMS group demonstrated increases in resting CBF specifically in regions known to mediate skill learning namely, the M1, cingulate cortex, putamen, hippocampus, and cerebellum. These results indicate that TMS applied concomitantly augments behavioral effects of motor practice, with corresponding neural plasticity in motor sequence learning network. These findings are the first demonstration of the behavioral and neural enhancing effects of TMS on slow motor practice and have direct application in neurorehabilitation where TMS could be applied in conjunction with physical therapy.

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Section: Discussionmentioning

confidence: 99%

Concurrent TMS to the primary motor cortex augments slow motor learning

et al. 2014

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“…Improving functions maybe, using the affected hand more in functional activities and also it has long been believed that the brains of children are felt to have more capability than adults for cortical reorganization and it has been suggested that children with asymmetric upper extremity motor control may also benefit from constraint therapy. Modified CIMT is effective in improving motor recovery in patients with hemiplegia because of increased size and shifting of cortical area neural firing after CIMT [4,13].…”

Section: Discussionmentioning

confidence: 99%

“…• Diagnosis of hemiplegic cerebral palsy Using the Box and Block Test, gross manual dexterity was determined as the maximum number of blocks transported from one compartment of a box to another in 1 min [11][12][13][14].…”

Section: Inclusion Criteriamentioning

confidence: 99%

Effects of Modified Constrained Induced Movement Therapy to Improve the Upper Limb Functional Activities and Gross Manual Dexterity on Hemiparetic Cerebral Palsy Children

Nagarani¹

2015

Int J Neurorehabilitation Eng

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Background: cerebral palsy is a neuro developmental disorder. It has various types. Hemiparetic cerebral palsy is a type in which the children have limitations in capacity to use the impaired upper limb on daily life activities. This study aims to find out the effects of modified Constraint induced Movement therapy ( modified CIMT) to improve the upper limb functional activities and gross manual dexterity among the children with hemiparetic cerebral palsy.

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“…At the second level, one randomised trial scoring 6/10 on the PEDro scale, and reported in two papers [24,25], provided evidence for sensitivity to change. Three additional studies added second-level evidence to understanding the capacity of ABILHAND-Kids to discriminate severity of cerebral palsy [20,21,26].…”

Section: Abilhand-kidsmentioning

confidence: 99%

“…Other RCTs scoring !6/10 on the PEDro scale were ineligible for consideration as they compared two treatment groups [e.g. 25,28].…”

Section: Abilhand-kidsmentioning

confidence: 99%

Upper limb function in everyday life of children with cerebral palsy: description and review of parent report measures

Wallen

Stewart

2014

Disability and Rehabilitation

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Understanding upper limb performance in everyday life, as perceived by children with cerebral palsy and their families, informs a comprehensive assessment and acknowledges the importance of the perspectives of child and family. Implications for Rehabilitation Cerebral palsy-specific self- or parent-report measures of upper limb performance in everyday life complement observational assessments in understanding upper limb performance CHEQ provides clinical information, ABILHAND-Kids is validated for children with unilateral and bilateral cerebral palsy and possesses the most robust psychometric properties, Revised PMAL measures unilateral upper limb use. No adequate measure for children under 2 years exists.

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Motor learning curve and long-term effectiveness of modified constraint-induced movement therapy in children with unilateral cerebral palsy: A randomized controlled trial

Cited by 41 publications

References 27 publications

Concurrent TMS to the primary motor cortex augments slow motor learning

Concurrent TMS to the primary motor cortex augments slow motor learning

Effects of Modified Constrained Induced Movement Therapy to Improve the Upper Limb Functional Activities and Gross Manual Dexterity on Hemiparetic Cerebral Palsy Children

Upper limb function in everyday life of children with cerebral palsy: description and review of parent report measures

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