Muscle Recruitment and Coordination following Constraint-Induced Movement Therapy with Electrical Stimulation on Children with Hemiplegic Cerebral Palsy: A Randomized Controlled Trial

Abstract

ObjectiveTo investigate changes of muscle recruitment and coordination following constraint-induced movement therapy, constraint-induced movement therapy plus electrical stimulation, and traditional occupational therapy in treating hand dysfunction.MethodsIn a randomized, single-blind, controlled trial, children with hemiplegic cerebral palsy were randomly assigned to receive constraint-induced movement therapy (n = 22), constraint-induced movement therapy plus electrical stimulation (n = 23), or traditional occupational therapy (n = 23). Three groups received a 2-week hospital-based intervention and a 6-month home-based exercise program following hospital-based intervention. Constraint-induced movement therapy involved intensive functional training of the involved hand during which the uninvolved hand was constrained. Electrical stimulation was applied on wrist extensors of the involved hand. Traditional occupational therapy involved functional unimanual and bimanual training. All children underwent clinical assessments and surface electromyography (EMG) at baseline, 2 weeks, 3 and 6 months after treatment. Surface myoelectric signals were integrated EMG, root mean square and cocontraction ratio. Clinical measures were grip strength and upper extremity functional test.ResultsConstraint-induced movement therapy plus electrical stimulation group showed both a greater rate of improvement in integrated EMG of the involved wrist extensors and cocontraction ratio compared to the other two groups at 3 and 6 months, as well as improving in root mean square of the involved wrist extensors than traditional occupational therapy group (p<0.05). Positive correlations were found between both upper extremity functional test scores and integrated EMG of the involved wrist as well as grip strength and integrated EMG of the involved wrist extensors (p<0.05).ConclusionsConstraint-induced movement therapy plus electrical stimulation is likely to produce the best outcome in improving muscle recruitment and coordination in children with hemiplegic cerebral palsy compared to constraint-induced movement therapy alone or traditional occupational therapy.Trial registrationchictr.org ChiCTR-TRC-13004041

Effectiveness of paediatric occupational therapy for children with disabilities: A systematic review

“…From this, 136 intervention outcome indicators were identified, whereby an intervention, with an individual target outcome was administered to specific diagnostic groups. Insufficient data was available for Schaaf, Dumont, Arbesman & May-Benson, 2018;Smith et al, 2014;Snider, Majnemer & Darsaklis, 2010;Storebø et al, 2011;Tatla et al, 2013;Tatla, Sauve, Jarus, Virji-Babul & Holsti, 2014;Vargas & Lucker, 2016;Westendorp et al, 2014;Whalen & Case-Smith, 2012;Xu, He, Mai, Yan & Chen, 2015;Zadnikar & Kastrin, 2011;Ziviani, Feeney, Rodger & Watter, 2010;Zwicker & Mayson, 2010); 10% (n = 14/130) were graded 'probably don't do it' (Yellow Measure) (Wallen & Gillies, 2006;Wells, Marquez & Wakely, 2018); and 4% (n = 6/135) were graded 'don't do it' (Red Stop) (Gringras et al, 2014;Katalinic et al, 2010).…”

Effect of Direction and Tension of Kinesio Taping Application on Sensorimotor Coordination

“…In particular, we examine whether KT applied with different directions and tensions may influence our sensorimotor task differently. It is recognized that muscle recruitment is closely related to global functional improvement of hand motion [41]. We therefore hypothesize that the facilitatory application of KT would increase the precision of synchronized movements by promoting the recruitment of muscle fibers and, consequently, by stabilizing the wrist joint in terms of motion control.…”

Defining Functional Therapy in Research Involving Children with Cerebral Palsy: A Systematic Review

“…Several different types of intervention approaches were referred to by authors as functional therapy. For example home-based or modified constraint-induced movement therapy (CIMT) involving functional training of the involved hand (Chen et al, 2013;de Brito Brandao, Mancini, Vaz, Pereira de Melo, & Fonseca, 2010;Gordon et al, 2011;Chen et al, 2014;Xu, He, Mai, Yan, & Chen, 2015), goal-directed functional therapy (GDT) (Ahl et al, 2005;Lowing, Bexelius, & Brogren Carlberg, 2009;Lowing, Bexelius, & Carlberg, 2010;Storvold & Jahnsen, 2010), and functional (physical) training program (Akbari, Javad Zadeh, Shahraki, & Jahanshahi Javaran, 2009;Blundell, Shepherd, Dean, Adams, & Cahill, 2003;Ferre et al, 2017;Gorter, Holty, Rameckers, Elvers, & Oostendorp, 2009;Ketelaar et al, 2001;Kusumoto, Nitta, & Takaki, 2016;Lee, Ko, Shin, & Lee, 2015;Liao, Liu, Liu, & Lin, 2007;Moura et al, 2017;Peungsuwan, Parasin, Siritaratiwat, Prasertnu, & Yamauchi, 2017;Rameckers, Duysens, Speth, Vles, & Smits-Engelsman, 2010;Rameckers, Speth, Duysens, Vles, & Smits-Engelsman, 2009;Scholtes et al, 2010;van Vulpen, de Groot, Rameckers, Becher, & Dallmeijer, 2017).…”

“…The age of participants included in the studies ranged from 1 to 18 years, the majority were school-aged children. According to the Surveillance of Cerebral Palsy in Europe (SCPE) terminology, eleven studies included only children with unilateral CP (Chen et al, 2013;de Brito Brandao et al, 2010;Ferre et al, 2017;Gordon et al, 2011;Chen et al, 2014;Moura et al, 2017;Rameckers et al, 2009;Sung et al, 2005;Xu et al, 2015). Eight studies included both unilateral and bilateral CP (Akbari et al, 2009;Ketelaar et al, 2001;Lowing et al, 2009;Peungsuwan et al, 2017;Scholtes et al, 2010;Storvold & Jahnsen, 2010;van Vulpen et al, 2017).…”