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Ching-yi Wu - One of the best experts on this subject based on the ideXlab platform.
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Sequencing bilateral robot-assisted arm Therapy and Constraint-Induced Therapy improves reach to press and trunk kinematics in patients with stroke
Journal of Neuroengineering and Rehabilitation, 2016Co-Authors: Yu-wei Hsieh, Ching-yi Wu, Rong Jiuan Liing, Tsan Hon Liou, Jen Wen HungAbstract:Background The combination of robot-assisted Therapy (RT) and a modified form of Constraint-Induced Therapy (mCIT) shows promise for improving motor function of patients with stroke. However, whether the changes of motor control strategies are concomitant with the improvements in motor function after combination of RT and mCIT (RT + mCIT) is unclear. This study investigated the effects of the sequential combination of RT + mCIT compared with RT alone on the strategies of motor control measured by kinematic analysis and on motor function and daily performance measured by clinical scales.
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Improvement of Upper Extremity Motor Control and Function After Home-Based Constraint Induced Therapy in Children With Unilateral Cerebral Palsy: Immediate and Long-Term Effects
Archives of Physical Medicine and Rehabilitation, 2014Co-Authors: Hsiehching Chen, Fei-chuan Chen, Lin-ju Kang, Chia-ling Chen, Ching-yi Wu, Weihsien HongAbstract:Objective: To investigate the long-term effects of home-based Constraint Induced Therapy (CIT) on motor control underlying functional change in children with unilateral cerebral palsy (CP). Design: Randomized controlled trial. Setting: Home based. Participants: Children with unilateral CP (NZ45; aged 6e12y) were randomly assigned to receive home-based CIT (nZ23) or traditional rehabilitation (TR) (nZ22). Interventions: Both groups received a 4-week therapist-based intervention at home. The home-based CIT involved intensive functional training of the more affected upper extremity during which the less affected one was restrained. The TR involved functional unimanual and bimanual training. Main Outcome Measures: Allchildrenunderwentkinematicandclinicalassessmentsatbaseline,4weeks(posttreatment),and3and6months(followup).Thereach-to-graspkinematicswerereactiontime(RT),normalizedmovementtime,normalizedmovementunit,peakvelocity(PV),maximumgrip aperture (MGA), and percentage of movement where MGA occurs. The clinical measures were the Peabody Developmental Motor Scales, Second Edition (PDMS-2), Bruininks-Oseretsky Test of Motor Proficiency (BOTMP), and Functional Independence Measure for children (WeeFIM). Results: The home-based CIT group showed a shorter RT (P
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Potential Predictors of Functional Outcomes After Home-Based Constraint-Induced Therapy for Children With Cerebral Palsy
American Journal of Occupational Therapy, 2014Co-Authors: Chia-ling Chen, Lin-ju Kang, Ching-yi Wu, Hsiehching Chen, Yu-wei HsiehAbstract:Yu-wei Hsieh, PhD, is Assistant Professor, Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan. OBJECTIVE. Our objective was to identify predictors for treatment outcomes after home-based ConstraintInduced Therapy (CIT) in children with cerebral palsy (CP). METHOD. Forty-three children (aged 4–12 yr) with CP were treated with individualized CIT at home for 4 wk. Potential predictors were age, sex, affected hand, and upper-extremity motor capacity measured by the Peabody Developmental Motor Scale, 2nd edition (PDMS–2). Outcomes were the Pediatric Motor Activity Log (PMAL) Amount of Hand Use and Quality of Hand Use subscales and the Functional Independence Measure for Children (WeeFIM). RESULTS. A higher PDMS–2 Visual–Motor Integration subscale score predicted a better WeeFIM score after home-based CIT (adjusted R 5 .35). Younger age predicted better performance on the PMAL Amount of Hand Use and Quality of Hand Use subscales (adjusted R 5 .06–.08) after home-based CIT. CONCLUSION. The potential predictors may allow occupational Therapy practitioners to target those children who will benefit most after home-based Constraint-Induced Therapy.
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effect of therapist based Constraint Induced Therapy at home on motor control motor performance and daily function in children with cerebral palsy a randomized controlled study
Clinical Rehabilitation, 2013Co-Authors: Chia-ling Chen, Fei-chuan Chen, Lin-ju Kang, Weihsien Hong, Hsiehching Chen, Ching-yi WuAbstract:Objective:To determine the effect of therapist-based Constraint-Induced Therapy at home on motor performance, daily function and reaching control for children with cerebral palsy.Design:A single-blinded, randomized controlled trial.Subjects:Forty-seven children (23 boys; 24 girls) with unilateral cerebral palsy, aged 6–12 years, were randomized to Constraint-Induced Therapy (n = 24) or traditional rehabilitation (n = 23).Interventions:Constraint-Induced Therapy involved intensive functional training of the more affected arm while the less affected arm was restrained. Traditional rehabilitation involved functional unilateral and bilateral arm training. Both groups received individualized therapist-based interventions at home for 3.5–4 hours/day, two days a week for four weeks.Main measures:Motor performance and daily function were measured by the Peabody Developmental Motor Scale, Second Edition and the Pediatric Motor Activity Log. Reaching control was assessed by the kinematics of reaction time, movement...
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Effects of Constraint-Induced Therapy Combined With Eye Patching on Functional Outcomes and Movement Kinematics in Poststroke Neglect
American Journal of Occupational Therapy, 2013Co-Authors: Ching-yi Wu, Tien-ni Wang, Yi-an Chen, Yu Ting Chen, Hsiang Ting Li, Pei-luen TsaiAbstract:OBJECTIVE. We investigated the effect of Constraint-Induced Therapy (CIT) plus eye patching (EP), CIT alone, and conventional treatment on functional performance, eye movement, and trunk–arm kinematics in stroke patients with neglect syndrome. METHOD. Twenty-four participants were recruited and randomly allocated to three intervention groups. All participants received intervention 2 hr/day, 5 days/wk, for 3 wk. Outcome measures included the Catherine Bergego Scale, eye movement, and trunk–arm kinematic analysis. RESULTS. The CIT 1 EP and CIT groups demonstrated larger improvements in functional performance than the control group. The CIT group showed better performance with left fixation points than the CIT1EP group and shorter reaction time than the control group. The CIT 1 EP group improved more in preplanned control and leftward trunk shift than the other two groups. CONCLUSION. CIT 1 EP and CIT were more effective interventions than conventional treatment of patients with neglect syndrome in daily functional performance.
Stephen J Page - One of the best experts on this subject based on the ideXlab platform.
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What are the “ingredients” of modified Constraint-Induced Therapy? An evidence-based review, recipe, and recommendations
Restorative Neurology and Neuroscience, 2013Co-Authors: Stephen J Page, Peter LevineAbstract:Modified Constraint Induced movement Therapy (mCIT) increases paretic upper extremity use and movement in all phases of stroke. Although fundamental to its appropriate implementation, specific details on day to day implementation on this promising family of therapies have not heretofore been published. Consequently, some integral behavioral facets of mCIT may be overlooked, while other approaches may be easily mistaken to constitute mCIT, during attempts to implement the Therapy. The purpose of this paper is to review mCIT, and to provide the clinician-reader with a detailed description of the “ingredients” of mCIT and their rationale, including clinical examples of these components. It is expected that a more complete understanding of the components comprising this promising approach will overcome knowledge barriers associated with its appropriate use, and encourage better patient management in clinical practice.
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Affected Upper-Extremity Movement Ability Is Retained 3 Months After Modified Constraint-Induced Therapy
American Journal of Occupational Therapy, 2011Co-Authors: Stephen J Page, Colleen Murray, Valerie HermannAbstract:The practicality and patient compliance of Constraint-Induced movement Therapy limit its application in many clinical environments. For more than a decade, the principal investigator's laboratory has shown efficacy of an outpatient, modified Constraint-Induced Therapy (mCIT). The current study examined whether participants administered mCIT retained motor changes 3 mo after intervention. The upper-extremity section of the Fugl-Meyer Impairment Scale (FM) and the Action Research Arm Test (ARA) were administered directly after mCIT intervention. Thirteen patients poststroke were tracked prospectively from directly after intervention concluded to 3 mo after intervention, at which time the FM and ARA were readministered. Three months after intervention, 25 of the 26 scores on the FM and ARA increased between the time after intervention and 3 months after intervention, reflecting continued increases in affected extremity movement ability. It is believed that the continued motor changes were caused by the comparatively larger number of extremity-use opportunities during the 10-wk mCIT intervention period. These opportunities encourage habitual extremity use even after the intervention period has concluded, leading to the changes observed.
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modified Constraint Induced Therapy combined with mental practice thinking through better motor outcomes
Stroke, 2009Co-Authors: Stephen J Page, Peter Levine, Jane KhouryAbstract:Background and Purpose— Modified Constraint-Induced Therapy (mCIT) is an outpatient Therapy encouraging repetitive, task-specific practice with the affected arm. mCIT has shown efficacy in all stages poststroke. Given its efficacy when combined with other Therapy regimens, the current study examined the efficacy of mental practice when combined with mCIT versus mCIT only using randomized, controlled methods. Method— Ten patients with chronic stroke (7 males; mean age, 61.4±3.02 years; age range, 48 to 79 years; mean time since stroke, 28.5 months; range, 13 to 42 months) exhibiting stable, affected arm motor deficits were administered mCIT, consisting of: (1) structured Therapy emphasizing affected arm use in functional activities 3 days/week for 10 weeks; and (2) less affected arm restraint 5 days/week for 5 hours. Both of these components were administered during a 10-week period. Subjects randomly assigned to the mCIT+mental practice experimental condition also received 30-minute mental practice sessio...
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modified Constraint Induced Therapy in chronic stroke results of a single blinded randomized controlled trial
Physical Therapy, 2008Co-Authors: Stephen J Page, Peter Levine, Anthony C Leonard, Jerzy P Szaflarski, Brett M KisselaAbstract:Background and Purpose: This single-blinded randomized controlled trial compared the efficacy of a reimbursable, outpatient, modified Constraint-Induced Therapy (mCIT) protocol (half-hour Therapy sessions occurring 3 days per week in which subjects used the more affected arm combined with less affected arm restriction 5 days per week for 5 hours; both of these regimens were administered during a 10-week period) with that of a time-matched exercise program for the more affected arm or a no-treatment control regimen. Subjects: Thirty-five subjects with chronic stroke participated in the study. Methods: The Action Research Arm Test (ARAT), Fugl-Meyer Assessment of Motor Recovery After Stroke (FM), and Motor Activity Log (MAL) were administered to the subjects. Results: After intervention, significant differences were observed on the ARAT and MAL Amount of Use and Quality of Movement scales, all in favor of the mCIT group. Discussion and Conclusion: The data affirm previous findings suggesting that this reimbursable, outpatient protocol increases more affected arm use and function. Magnitude of changes was consistent with those reported in more intense protocols, such as Constraint-Induced Therapy.
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Modified Constraint-Induced Therapy Extension: Using Remote Technologies to Improve Function
Archives of Physical Medicine and Rehabilitation, 2007Co-Authors: Stephen J Page, Peter LevineAbstract:Abstract Page SJ, Levine P. Modified Constraint-Induced Therapy extension: using remote technologies to improve function. Objective To determine efficacy of a modified Constraint-Induced Therapy extension (mCITE) protocol, in which persons with stroke participated in Therapy sessions via the Internet. Design Pre-post, single-blinded case series. Setting Outpatient clinic. Participants Four people with stroke who experienced stroke more than 1 year prior to study entry exhibiting upper-limb hemiparesis and nonuse. Intervention Subjects participated in online, 30-minute Therapy sessions, 3 times a week for 10 weeks using personal computer-based cameras and free network meeting software. During the same period, subjects' less affected hands and wrists were restrained every weekday for 5 hours. Patients completed online logs to document restraint use and activities practiced at home. Main Outcome Measures The Motor Activity Log (MAL) and Wolf Motor Function Test (WMFT). We also used a structured interview to ask patients about their satisfaction with the protocol. Results After intervention, subjects exhibited marked improvements in more affected arm use (+2.7, +2.06, +1.7, +2,83, respectively), quality of movement (+2.1, +2.1, +2.03, +1.9, respectively), as measured by the MAL, and speed increases while performing WMFT tasks. Subjects' mCITE satisfaction and adherence were high, and motor changes translated to ability to perform valued activities. Conclusions A home-based, modified Constraint-Induced movement Therapy program is feasible and appears to increase more affected arm use and function using commercially available, inexpensive technologies.
Peter Levine - One of the best experts on this subject based on the ideXlab platform.
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What are the “ingredients” of modified Constraint-Induced Therapy? An evidence-based review, recipe, and recommendations
Restorative Neurology and Neuroscience, 2013Co-Authors: Stephen J Page, Peter LevineAbstract:Modified Constraint Induced movement Therapy (mCIT) increases paretic upper extremity use and movement in all phases of stroke. Although fundamental to its appropriate implementation, specific details on day to day implementation on this promising family of therapies have not heretofore been published. Consequently, some integral behavioral facets of mCIT may be overlooked, while other approaches may be easily mistaken to constitute mCIT, during attempts to implement the Therapy. The purpose of this paper is to review mCIT, and to provide the clinician-reader with a detailed description of the “ingredients” of mCIT and their rationale, including clinical examples of these components. It is expected that a more complete understanding of the components comprising this promising approach will overcome knowledge barriers associated with its appropriate use, and encourage better patient management in clinical practice.
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modified Constraint Induced Therapy combined with mental practice thinking through better motor outcomes
Stroke, 2009Co-Authors: Stephen J Page, Peter Levine, Jane KhouryAbstract:Background and Purpose— Modified Constraint-Induced Therapy (mCIT) is an outpatient Therapy encouraging repetitive, task-specific practice with the affected arm. mCIT has shown efficacy in all stages poststroke. Given its efficacy when combined with other Therapy regimens, the current study examined the efficacy of mental practice when combined with mCIT versus mCIT only using randomized, controlled methods. Method— Ten patients with chronic stroke (7 males; mean age, 61.4±3.02 years; age range, 48 to 79 years; mean time since stroke, 28.5 months; range, 13 to 42 months) exhibiting stable, affected arm motor deficits were administered mCIT, consisting of: (1) structured Therapy emphasizing affected arm use in functional activities 3 days/week for 10 weeks; and (2) less affected arm restraint 5 days/week for 5 hours. Both of these components were administered during a 10-week period. Subjects randomly assigned to the mCIT+mental practice experimental condition also received 30-minute mental practice sessio...
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modified Constraint Induced Therapy in chronic stroke results of a single blinded randomized controlled trial
Physical Therapy, 2008Co-Authors: Stephen J Page, Peter Levine, Anthony C Leonard, Jerzy P Szaflarski, Brett M KisselaAbstract:Background and Purpose: This single-blinded randomized controlled trial compared the efficacy of a reimbursable, outpatient, modified Constraint-Induced Therapy (mCIT) protocol (half-hour Therapy sessions occurring 3 days per week in which subjects used the more affected arm combined with less affected arm restriction 5 days per week for 5 hours; both of these regimens were administered during a 10-week period) with that of a time-matched exercise program for the more affected arm or a no-treatment control regimen. Subjects: Thirty-five subjects with chronic stroke participated in the study. Methods: The Action Research Arm Test (ARAT), Fugl-Meyer Assessment of Motor Recovery After Stroke (FM), and Motor Activity Log (MAL) were administered to the subjects. Results: After intervention, significant differences were observed on the ARAT and MAL Amount of Use and Quality of Movement scales, all in favor of the mCIT group. Discussion and Conclusion: The data affirm previous findings suggesting that this reimbursable, outpatient protocol increases more affected arm use and function. Magnitude of changes was consistent with those reported in more intense protocols, such as Constraint-Induced Therapy.
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Modified Constraint-Induced Therapy Extension: Using Remote Technologies to Improve Function
Archives of Physical Medicine and Rehabilitation, 2007Co-Authors: Stephen J Page, Peter LevineAbstract:Abstract Page SJ, Levine P. Modified Constraint-Induced Therapy extension: using remote technologies to improve function. Objective To determine efficacy of a modified Constraint-Induced Therapy extension (mCITE) protocol, in which persons with stroke participated in Therapy sessions via the Internet. Design Pre-post, single-blinded case series. Setting Outpatient clinic. Participants Four people with stroke who experienced stroke more than 1 year prior to study entry exhibiting upper-limb hemiparesis and nonuse. Intervention Subjects participated in online, 30-minute Therapy sessions, 3 times a week for 10 weeks using personal computer-based cameras and free network meeting software. During the same period, subjects' less affected hands and wrists were restrained every weekday for 5 hours. Patients completed online logs to document restraint use and activities practiced at home. Main Outcome Measures The Motor Activity Log (MAL) and Wolf Motor Function Test (WMFT). We also used a structured interview to ask patients about their satisfaction with the protocol. Results After intervention, subjects exhibited marked improvements in more affected arm use (+2.7, +2.06, +1.7, +2,83, respectively), quality of movement (+2.1, +2.1, +2.03, +1.9, respectively), as measured by the MAL, and speed increases while performing WMFT tasks. Subjects' mCITE satisfaction and adherence were high, and motor changes translated to ability to perform valued activities. Conclusions A home-based, modified Constraint-Induced movement Therapy program is feasible and appears to increase more affected arm use and function using commercially available, inexpensive technologies.
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modified Constraint Induced Therapy in patients with chronic stroke exhibiting minimal movement ability in the affected arm
Physical Therapy, 2007Co-Authors: Stephen J Page, Peter LevineAbstract:Background and Purpose The purpose of this study was to determine the efficacy of a reimbursable, outpatient modified Constraint-Induced Therapy (mCIT) protocol administered to subjects with chronic stroke who initially exhibited minimal movement ability in their affected wrists and fingers. Subjects The subjects were 4 individuals who had experienced a stroke more than 1 year prior to study entry (mean age [±SD]=60.25±1.98 years, mean time since stroke=37.5±23.2 months). Method A multiple-baseline, preintervention-postintervention, single-blinded case series design was used. The intervention consisted of structured, ½-hour Therapy sessions emphasizing affected arm use in valued activities, occurring 3 times per week for 10 weeks. Subjects’ less affected arms also were restrained 5 days per week for 5 hours per day during the same 10-week period. The main outcome measures were the Action Research Arm Test (ARAT), the Motor Activity Log (MAL), and the Fugl-Meyer Assessment of Motor Recovery (FM). Results The subjects exhibited improvements in use of the more affected arm (+1.9, +1.8, +1.7, and +2.3 for subjects 1 through 4, respectively) and in quality of movement (+1.5, +2.1, +1.63, and +1.9 for subjects 1 through 4, respectively), as measured by the MAL. They also exhibited reduced impairment, as measured by the FM (+5.0, +6.5, +5.5, and +5.0 for subjects 1 through 4, respectively), and increased fine motor skill movement, as measured by the ARAT (+7.5, +7.0, +7.0, and +5.5 for subjects 1 through 4, respectively). Discussion and Conclusion The findings demonstrated that mCIT participation was efficacious because it led to increased use of the affected arm and of function and to increased ability to perform valued activities. The subjects reported some new ability to perform some valued activities. These outcomes are significant because few therapies are believed to effectively increase use of the affected arm and function in this population.
Chia-ling Chen - One of the best experts on this subject based on the ideXlab platform.
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Younger Children with Cerebral Palsy Respond Better Than Older Ones to Therapist-Based Constraint-Induced Therapy at Home on Functional Outcomes and Motor Control.
Physical & Occupational Therapy in Pediatrics, 2015Co-Authors: Hsiehching Chen, Fei-chuan Chen, Lin-ju Kang, Chia-ling Chen, Katie P.h. WuAbstract:ABSTRACTAims: To examine the differences in efficacy of home-based Constraint-Induced Therapy (CIT) on functional outcomes and motor control in two age groups of children with cerebral palsy (CP). Methods: Twenty-three children with spastic unilateral CP receiving 4-week home-based CIT by a therapist were divided into younger (6–8 years; n = 11) and older (9–12 years; n = 12) groups. The home-based CIT involved intensive functional training of the more affected upper-limb while restraining the less affected upper-limb. The outcome measures were Peabody Developmental Motor Scale-2nd edition (PDMS-2) that was being used in a modified way, Functional Independence Measure for Children (WeeFIM), and reach-to-grasp kinematic parameters, including reaction time (RT), normalized movement time (MT), normalized movement units (MUs), peak velocity (PV), and maximum grip aperture (MGA). The outcome measures were assessed at baseline, 4-weeks (post-treatment), 3- and 6-months (follow-up). Results: The younger group sh...
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Improvement of Upper Extremity Motor Control and Function After Home-Based Constraint Induced Therapy in Children With Unilateral Cerebral Palsy: Immediate and Long-Term Effects
Archives of Physical Medicine and Rehabilitation, 2014Co-Authors: Hsiehching Chen, Fei-chuan Chen, Lin-ju Kang, Chia-ling Chen, Ching-yi Wu, Weihsien HongAbstract:Objective: To investigate the long-term effects of home-based Constraint Induced Therapy (CIT) on motor control underlying functional change in children with unilateral cerebral palsy (CP). Design: Randomized controlled trial. Setting: Home based. Participants: Children with unilateral CP (NZ45; aged 6e12y) were randomly assigned to receive home-based CIT (nZ23) or traditional rehabilitation (TR) (nZ22). Interventions: Both groups received a 4-week therapist-based intervention at home. The home-based CIT involved intensive functional training of the more affected upper extremity during which the less affected one was restrained. The TR involved functional unimanual and bimanual training. Main Outcome Measures: Allchildrenunderwentkinematicandclinicalassessmentsatbaseline,4weeks(posttreatment),and3and6months(followup).Thereach-to-graspkinematicswerereactiontime(RT),normalizedmovementtime,normalizedmovementunit,peakvelocity(PV),maximumgrip aperture (MGA), and percentage of movement where MGA occurs. The clinical measures were the Peabody Developmental Motor Scales, Second Edition (PDMS-2), Bruininks-Oseretsky Test of Motor Proficiency (BOTMP), and Functional Independence Measure for children (WeeFIM). Results: The home-based CIT group showed a shorter RT (P
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Potential Predictors of Functional Outcomes After Home-Based Constraint-Induced Therapy for Children With Cerebral Palsy
American Journal of Occupational Therapy, 2014Co-Authors: Chia-ling Chen, Lin-ju Kang, Ching-yi Wu, Hsiehching Chen, Yu-wei HsiehAbstract:Yu-wei Hsieh, PhD, is Assistant Professor, Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan. OBJECTIVE. Our objective was to identify predictors for treatment outcomes after home-based ConstraintInduced Therapy (CIT) in children with cerebral palsy (CP). METHOD. Forty-three children (aged 4–12 yr) with CP were treated with individualized CIT at home for 4 wk. Potential predictors were age, sex, affected hand, and upper-extremity motor capacity measured by the Peabody Developmental Motor Scale, 2nd edition (PDMS–2). Outcomes were the Pediatric Motor Activity Log (PMAL) Amount of Hand Use and Quality of Hand Use subscales and the Functional Independence Measure for Children (WeeFIM). RESULTS. A higher PDMS–2 Visual–Motor Integration subscale score predicted a better WeeFIM score after home-based CIT (adjusted R 5 .35). Younger age predicted better performance on the PMAL Amount of Hand Use and Quality of Hand Use subscales (adjusted R 5 .06–.08) after home-based CIT. CONCLUSION. The potential predictors may allow occupational Therapy practitioners to target those children who will benefit most after home-based Constraint-Induced Therapy.
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effect of therapist based Constraint Induced Therapy at home on motor control motor performance and daily function in children with cerebral palsy a randomized controlled study
Clinical Rehabilitation, 2013Co-Authors: Chia-ling Chen, Fei-chuan Chen, Lin-ju Kang, Weihsien Hong, Hsiehching Chen, Ching-yi WuAbstract:Objective:To determine the effect of therapist-based Constraint-Induced Therapy at home on motor performance, daily function and reaching control for children with cerebral palsy.Design:A single-blinded, randomized controlled trial.Subjects:Forty-seven children (23 boys; 24 girls) with unilateral cerebral palsy, aged 6–12 years, were randomized to Constraint-Induced Therapy (n = 24) or traditional rehabilitation (n = 23).Interventions:Constraint-Induced Therapy involved intensive functional training of the more affected arm while the less affected arm was restrained. Traditional rehabilitation involved functional unilateral and bilateral arm training. Both groups received individualized therapist-based interventions at home for 3.5–4 hours/day, two days a week for four weeks.Main measures:Motor performance and daily function were measured by the Peabody Developmental Motor Scale, Second Edition and the Pediatric Motor Activity Log. Reaching control was assessed by the kinematics of reaction time, movement...
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Logistic Regression Analyses for Predicting Clinically Important Differences in Motor Capacity, Motor Performance, and Functional Independence after Constraint-Induced Therapy in Children with Cerebral Palsy.
Research in Developmental Disabilities, 2013Co-Authors: Tien-ni Wang, Chia-ling Chen, Ching-yi Wu, Jeng-yi Shieh, Lu LuAbstract:Abstract Given the growing evidence for the effects of Constraint-Induced Therapy (CIT) in children with cerebral palsy (CP), there is a need for investigating the characteristics of potential participants who may benefit most from this intervention. This study aimed to establish predictive models for the effects of pediatric CIT on motor and functional outcomes. Therapists administered CIT to 49 children (aged 3–11 years) with CP. Sessions were 1–3.5 h a day, twice a week, for 3–4 weeks. Parents were asked to document the number of restraint hours outside of the Therapy sessions. Domains of treatment outcomes included motor capacity (measured by the Peabody Developmental Motor Scales II), motor performance (measured by the Pediatric Motor Activity Log), and functional independence (measured by the Pediatric Functional Independence Measure). Potential predictors included age, affected side, compliance (measured by time of restraint), and the initial level of motor impairment severity. Tests were administered before, immediately after, and 3 months after the intervention. Logistic regression analyses showed that total amount of restraint time was the only significant predictor for improved motor capacity immediately after CIT. Younger children who restrained the less affected arm for a longer time had a greater chance to achieve clinically significant improvements in motor performance. For outcomes of functional independence in daily life, younger age was associated with clinically meaningful improvement in the self-care domain. Baseline motor abilities were significantly predictive of better improvement in mobility and cognition. Significant predictors varied according to the aspects of motor outcomes after 3 months of follow-up. The potential predictors identified in this study allow clinicians to target those children who may benefit most from CIT.
Yuehtsen Chen - One of the best experts on this subject based on the ideXlab platform.
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Constraint Induced Therapy versus dose matched control intervention to improve motor ability basic extended daily functions and quality of life in stroke
Neurorehabilitation and Neural Repair, 2009Co-Authors: Ching-yi Wu, Yuehtsen ChenAbstract:Background. Trials of Constraint-Induced movement Therapy (CIT) to improve upper extremity function after stroke have usually not included an actively treated control group. Objective. This study compared a modified CIT intervention with a dose-matched control intervention that included restraint of the less affected hand and assessed for differences in motor and functional performance and health-related quality of life. Methods. This 2-group randomized controlled trial, using pretreatment and posttreatment measures, enrolled 32 patients within 6 to 40 months after onset of a first stroke (mean age, 55.7 years). They received either CIT (restraint of the less affected limb combined with intensive training of the affected limb for 2 hours daily 5 days per week for 3 weeks and restraint of the less affected hand for 5 hours outside of the rehabilitation training) or a conventional intervention with hand restraint for the same duration. Outcome measures were the Fugl-Meyer Assessment, Functional Independence...
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Constraint-Induced Therapy versus dose-matched control intervention to improve motor ability, basic/extended daily functions, and quality of life in stroke.
Neurorehabilitation and Neural Repair, 2008Co-Authors: Ching-yi Wu, Yuehtsen ChenAbstract:Background. Trials of Constraint-Induced movement Therapy (CIT) to improve upper extremity function after stroke have usually not included an actively treated control group. Objective. This study compared a modified CIT intervention with a dose-matched control intervention that included restraint of the less affected hand and assessed for differences in motor and functional performance and health-related quality of life. Methods. This 2-group randomized controlled trial, using pretreatment and posttreatment measures, enrolled 32 patients within 6 to 40 months after onset of a first stroke (mean age, 55.7 years). They received either CIT (restraint of the less affected limb combined with intensive training of the affected limb for 2 hours daily 5 days per week for 3 weeks and restraint of the less affected hand for 5 hours outside of the rehabilitation training) or a conventional intervention with hand restraint for the same duration. Outcome measures were the Fugl-Meyer Assessment, Functional Independence...