title: The short-term effects of combined modified constraint-induced movement therapy and botulinum toxin injection for children with spastic hemiplegic cerebral palsy.
abstract: 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.
authors.affiliation: Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: E S
authors.initials: ES
authors.lastname: Park
authors.forename: D-W
authors.initials: DW
authors.lastname: Rha
authors.forename: J D
authors.initials: JD
authors.lastname: Lee
authors.forename: J K
authors.initials: JK
authors.lastname: Yoo
authors.forename: W H
authors.initials: WH
authors.lastname: Chang
mesh_terms: 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
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A