The short-term effects of combined modified constraint-induced movement therapy and botulinum toxin injection for children with spastic hemiplegic cerebral palsy.
OBJECTIVE
The aim of this study was to investigate whether modified constraint-induced movement therapy (mCIMT) following a botulinum type A toxin (BoNT-A) injection enhances the effects of the BoNT-A injection into the spastic upper limb of children with hemiplegic cerebral palsy (CP).


METHODS
A combined therapy with mCIMT and BoNT-A was given to 17 children in group A. Fifteen children in group B received only the BoNT-A injection. The muscle tone, the movement pattern, and the How Often and the How Well scales in the revised Pediatric Motor Activity Log (revised PMAL) were assessed before and 3 weeks after intervention.


RESULTS
Three participants in group A dropped out due to poor tolerance of mCIMT. There were significant improvements in the muscle tone and the movement patterns for both groups (p<0.05), and the changes were not significantly different between the two groups. The How Often and the How Well scales in the revised PMAL were significantly improved in group A (p<0.05), but not in group B.


CONCLUSIONS
A combined therapy of mCIMT and BoNT-A seems to be helpful to enhance the effects of the BoNT-A injection in the functional use of the affected limb in children with hemiplegic CP.
Park
E S
ES
Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.
Rha
D-W
DW
Lee
J D
JD
Yoo
J K
JK
Chang
W H
WH
D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000150:complications / Q000188:drug therapy* / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009043:Motor Activity / Q000502:physiology; D009460:Neurologic Examination; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D026741:Physical Therapy Modalities; D012149:Restraint, Physical / Q000379:methods*; D016896:Treatment Outcome
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A