Upper limb function and brain reorganization after constraint-induced movement therapy in children with hemiplegia.
OBJECTIVE
The aims of this study were to (1) investigate the effectiveness of CIMT for children with hemiplegia, (2) determine the feasibility of using fMRI for describing brain activity patterns before and after CIMT and (3) describe changes in brain reorganization after CIMT in children with hemiplegia using fMRI.


METHODS
Before and after study with one group.


METHODS
Ten children aged 7-14 years (M = 11.0, SD = 2.5) with hemiplegia received CIMT over a 2-week period using a before and after design. Clinical measures included the Melbourne Assessment of Unilateral Upper Limb Function, upper limb kinematics and parent questionnaire. Children were measured with fMRI before and after CIMT.


RESULTS
Findings showed that CIMT may be effective at improving upper limb function in some, but not all children; those children with a moderate degree of impairment seemed to benefit the most. fMRI findings correlated moderately with clinical measures.


CONCLUSIONS
Although unique challenges with fMRI data collection exist for this population, it provides potentially valuable information to better understand mechanisms of change after interventions such as CIMT.
Cope
Steven M
SM
Concordia University Wisconsin, Rehabilitation Science, Mequon, WI 53097, USA. steven.cope@cuw.edu
Liu
Xue-Cheng
XC
Verber
Matthew D
MD
Cayo
Christine
C
Rao
Stephen
S
Tassone
J Channing
JC
D000293:Adolescent; D001696:Biomechanical Phenomena; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping; D002648:Child; D005081:Exercise Therapy; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006429:Hemiplegia / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D009068:Movement / Q000502:physiology; D009473:Neuronal Plasticity / Q000502:physiology*; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology; D012044:Regression Analysis; D012149:Restraint, Physical / Q000502:physiology; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology*