| To constrain or not to constrain, and other stories of intensive upper extremity training for children with unilateral cerebral palsy. | |
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MedLine Citation:
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PMID: 21950396 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Impaired hand function is among the most functionally disabling symptoms of unilateral cerebral palsy. Evidence-based treatment approaches are generally lacking. However, recent approaches providing intensive upper extremity training appear promising. In this review, we first describe two such approaches, constraint-induced movement therapy (CIMT) and bimanual training (hand-arm bimanual intensive therapy). We then summarize findings across more than 100 participants in our CIMT/bimanual training studies since 1997. We show that (1) at high intensities, CIMT and bimanual training improve dexterity and bimanual upper extremity use; (2) bimanual training may allow direct practice of functionally meaningful goals, and such practice may transfer to unpracticed goals and improve bimanual coordination; (3) 90 hours of CIMT and bimanual training leads to greater improvements than 60 hours of the same treatments; (4) higher doses may be required for bimanual training; (5) increased dosing frequency and shaping may be needed for older children; and (6) combined CIMT/bimanual approaches may be useful, but require sufficient intensity. Together these findings suggest that dosage (treatment amount and frequency), more so than ingredients, may well be the key to successful training protocols, especially for older children. Such rehabilitation efforts should be 'child-friendly', and as least invasive as possible, especially because these approaches may be provided throughout development. |
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Authors:
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Andrew M Gordon |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Developmental medicine and child neurology Volume: 53 Suppl 4 ISSN: 1469-8749 ISO Abbreviation: Dev Med Child Neurol Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-09-28 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0006761 Medline TA: Dev Med Child Neurol Country: England |
Other Details:
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Languages: eng Pagination: 56-61 Citation Subset: IM |
Copyright Information:
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© The Author. Developmental Medicine & Child Neurology © 2011 Mac Keith Press. |
Affiliation:
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Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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