title: Changes in diffusion tensor tractographic findings associated with constraint-induced movement therapy in young children with cerebral palsy.
abstract: OBJECTIVE
  The objective of the study was to determine whether constraint-induced movement therapy (CIMT) could lead to changes in diffusion tensor tractography (DTT) associated with clinical improvement in young children with unilateral cerebral palsy (CP).
  
  
  METHODS
  A standardized pediatric CIMT protocol (4weeks, 120h of constraint) was used on 10 children with unilateral CP who were younger than 5years. DTT was performed in five participants before and after the intervention. Clinical outcome was measured by using the Pediatric Motor Activity Log (PMAL), Quality of Upper Extremity Skills Test (QUEST), and self-care domain of the Pediatric Evaluation of Disability Inventory.
  
  
  RESULTS
  In two patients, the affected corticospinal tract (CST) visible on pretreatment DTT became more prominent on posttreatment DTT. In one patient, the affected CST was not visible on pretreatment DTT, but was visible on posttreatment DTT. All the clinical outcomes significantly improved in the CIMT group compared with the control group. Changes in the PMAL how often scale (PMAL-HO) score significantly differed between the CIMT and control groups.
  
  
  CONCLUSIONS
  Changes in the properties of the affected CST on DTT were accompanied with improved arm function after CIMT in the children with CP.
  
  
  CONCLUSIONS
  CIMT might lead to CST reorganization in young children with CP.
authors.affiliation: Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea.
authors.forename: Jeong-Yi
authors.initials: JY
authors.lastname: Kwon
authors.affiliation: Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea; Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Republic of Korea.
authors.forename: Won Hyuk
authors.initials: WH
authors.lastname: Chang
authors.affiliation: Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea; Department of Physical and Rehabilitation Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Republic of Korea.
authors.forename: Hyun Jung
authors.initials: HJ
authors.lastname: Chang
authors.affiliation: Department of Pediatric Rehabilitation, Seoul, Republic of Korea.
authors.forename: Sook-Hee
authors.initials: SH
authors.lastname: Yi
authors.affiliation: Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea.
authors.forename: Min-Young
authors.initials: MY
authors.lastname: Kim
authors.affiliation: Department of Physical and Rehabilitation Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Republic of Korea.
authors.forename: Eun-Hye
authors.initials: EH
authors.lastname: Kim
authors.affiliation: Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea; Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Republic of Korea. Electronic address: yun1225.kim@samsung.com.
authors.forename: Yun-Hee
authors.initials: YH
authors.lastname: Kim
mesh_terms: D002547:Cerebral Palsy / Q000503:physiopathology* / Q000628:therapy*; D002675:Child, Preschool; D056324:Diffusion Tensor Imaging / Q000639:trends*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D015915:Motion Therapy, Continuous Passive / Q000379:methods / Q000639:trends*; D011712:Pyramidal Tracts / Q000503:physiopathology*; D016037:Single-Blind Method; D034941:Upper Extremity / Q000503:physiopathology
keywords: Cerebral palsy; Constraint-induced movement therapy; Corticospinal tract; Diffusion tensor tractography