title: An ecological approach of Constraint Induced Movement Therapy for 2-3-year-old children: a randomized control trial.
abstract: The aim was to evaluate the effect of Eco-CIMT in young children with unilateral cerebral palsy in a randomized controlled crossover design. The training was implemented within the regular pediatric services, provided by the child's parents and/or preschool teacher and supervised by the child's regular therapist.
  
  
  METHODS
  Twenty-five children (mean age 28.8 months [SD 11.2], 72% male) participated. Assisting Hand Assessment (AHA) was used as the outcome measure. The Eco-CIMT was provided for 2h a day over a period of two months. Children were randomized into two groups and started either with Eco-CIMT or as controls with a four-month washout period before crossing over.
  
  
  RESULTS
  A significant effect of Eco-CIMT was found when compared to the control period, and the estimated treatment effect was 5.47 (95% C.I. 2.93-8.02) (including both Group 1 and Group 2) (p < 0.001). The non-significant estimated carryover effect allowed us to collapse the two groups based on estimates from the ANOVA model. No clear relationship to hours of training, age or general attitudes of mastery was found.
  
  
  CONCLUSIONS
  Eco-CIMT influenced development more than ordinary treatment at this age when Eco-CIMT was performed by parents and preschool teachers supervised by the child's ordinary therapist.
authors.affiliation: Neuropediatric Unit, Department of Women's and Children's Health, Karolinska Institutet, 171 76 Stockholm, Sweden. ann-christin.eliasson@ki.se
authors.forename: Ann-Christin
authors.initials: AC
authors.lastname: Eliasson
authors.forename: Karin
authors.initials: K
authors.lastname: Shaw
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Berg
authors.forename: Lena
authors.initials: L
authors.lastname: Krumlinde-Sundholm
mesh_terms: D000203:Activities of Daily Living; D002547:Cerebral Palsy / Q000503:physiopathology* / Q000534:rehabilitation*; D002662:Child Health Services; D002675:Child, Preschool; D018592:Cross-Over Studies; D004777:Environment; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006225:Hand / Q000502:physiology*; D006801:Humans; D007223:Infant; D008297:Male; D009068:Movement; D012149:Restraint, Physical / Q000379:methods*