title: Effect of treatment environment on modified constraint-induced movement therapy results in children with spastic hemiplegic cerebral palsy: a randomized controlled trial.
abstract: OBJECTIVE
  To determine the effects of treatment environment (home and clinic) on results of modified constraint-induced movement therapy (modified CIMT) in children with spastic hemiplegic cerebral palsy.
  
  
  METHODS
  In a single-blinded, randomized, controlled trial, 14 children with spastic hemiplegic cerebral palsy (5 females, 9 males; mean age: 74 months) received 15 hours of modified CIMT, occurring three times/week for 10 sessions every other day in two randomly assigned groups. Each session lasts one and half hours. Treatment environment for intervention group (n = 7) was home and for control group (n = 7) was clinic. Measures were conducted pre, post and 3 months after treatment period by pediatrics motor activity log and subtests 5 (upper limb coordination) and 8 (upper limb speed and dexterity) of Bruininks-Oseretsky test of motor proficiency. Sample randomization and data analysis by analysis of variance with repeated measures were conducted by SPSS-16 software in α level set at p < 0.05.
  
  
  RESULTS
  All subjects showed significant improvement (p < 0.01) in post-test measures except subtest 5 of Bruininks-Oseretsky test of motor proficiency. In contrast to clinic group, subjects in home showed significantly continued improvement at follow-up session in all measures.
  
  
  CONCLUSIONS
  Modified CIMT is effective in improving upper limb function in children with spastic hemiplegic cerebral palsy. In addition, more improved performance in home group places the practice in natural context as the preferred method for treatment of these children.
authors.affiliation: Department of Occupational Therapy, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. rostamihr@ajums.ac.ir
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Rostami
authors.forename: R Azizi
authors.initials: RA
authors.lastname: Malamiri
mesh_terms: D000704:Analysis of Variance; D002547:Cerebral Palsy / Q000534:rehabilitation*; D002648:Child; D004185:Disability Evaluation; D004777:Environment; D005260:Female; D006801:Humans; D007103:Immobilization / Q000379:methods*; D008297:Male; D009048:Motor Skills; D016037:Single-Blind Method; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D034941:Upper Extremity