title: Is outcome of constraint-induced movement therapy in unilateral cerebral palsy dependent on corticomotor projection pattern and brain lesion characteristics?
abstract: OBJECTIVE
  The aim of the study was to explore individual variations in outcome of hand function after constraint-induced movement therapy (CIMT) in relation to the organization of corticomotor projection and brain lesion characteristics in participants with unilateral cerebral palsy (CP).
  
  
  METHODS
  Sixteen participants (eight males, eight females; mean age 13 y, [SD 2 y] range 10-16 y) with unilateral CP (nine right-sided; Manual Ability Classification System [MACS] level I, n=1; level II, n=15) who participated in a 2-week CIMT day camp (63 h) were included in the study. Various aspects of hand function were measured by the Jebsen-Taylor Hand Function Test (JTHFT), the Assisting Hand Assessment (AHA), and the Melbourne Assessment, both before and after the day camp. Transcranial magnetic stimulation was used to explore the corticomotor organization, and brain lesion characteristics were described by visual assessment of conventional structural magnetic resonance images.
  
  
  RESULTS
  At a group level, the training was associated with significant improvements in JTHFT (p=0.003) and AHA (p=0.046), but not in Melbourne Assessment scores. Improvements were found in all types of corticomotor projection patterns, i.e. contralateral, mixed, and ipsilateral. There was no relationship between functional improvement and brain lesion characteristics.
  
  
  CONCLUSIONS
  Individuals with CP experience improved motor outcomes after CIMT, independent of corticomotor projection pattern and lesion characteristics.
authors.affiliation: Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.
authors.forename: Mominul
authors.initials: M
authors.lastname: Islam
authors.forename: Linda
authors.initials: L
authors.lastname: Nordstrand
authors.forename: Linda
authors.initials: L
authors.lastname: Holmström
authors.forename: Annika
authors.initials: A
authors.lastname: Kits
authors.forename: Hans
authors.initials: H
authors.lastname: Forssberg
authors.forename: Ann-Christin
authors.initials: AC
authors.lastname: Eliasson
mesh_terms: D000293:Adolescent; D001921:Brain / Q000503:physiopathology*; D002547:Cerebral Palsy / Q000503:physiopathology* / Q000534:rehabilitation; D002648:Child; D004185:Disability Evaluation; D005260:Female; D007839:Functional Laterality; D006225:Hand / Q000502:physiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009048:Motor Skills / Q000502:physiology*; D026741:Physical Therapy Modalities; D050781:Transcranial Magnetic Stimulation / Q000379:methods; D016896:Treatment Outcome