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Children with Cerebral Palsy Return to Baseline Community Arm Movement after Constraint Induced Movement Therapy

Brianna M. Goodwin, Emily K. Sabelhaus, Ying-Chun Pan, Kristie F. Bjornson, Kelly L. D. Pham, William O. Walker, View ORCID ProfileKatherine M. Steele
doi: https://doi.org/10.1101/667246
Brianna M. Goodwin
1Department of Mechanical Engineering, University of Washington, Seattle, WA, USA
2Rehabilitation Medicine, Seattle Children’s Hospital, Seattle, WA, USA
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Emily K. Sabelhaus
2Rehabilitation Medicine, Seattle Children’s Hospital, Seattle, WA, USA
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Ying-Chun Pan
2Rehabilitation Medicine, Seattle Children’s Hospital, Seattle, WA, USA
3Department of Bioengineering, University of Washington, Seattle, WA, USA
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Kristie F. Bjornson
4Department of Pediatrics, University of Washington, Seattle WA, USA
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Kelly L. D. Pham
5Physical Medicine & Rehabilitation, University of Washington, Seattle, WA, USA
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William O. Walker
2Rehabilitation Medicine, Seattle Children’s Hospital, Seattle, WA, USA
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Katherine M. Steele
1Department of Mechanical Engineering, University of Washington, Seattle, WA, USA
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  • ORCID record for Katherine M. Steele
  • For correspondence: kmsteele@uw.edu
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Abstract

Importance Constraint Induced Movement Therapy (CIMT) is a common treatment for children with unilateral cerebral palsy (CP). While clinic-based assessments have demonstrated improvements in arm function after CIMT, quantifying if these changes are translated and sustained outside of a clinic setting remains unclear.

Objective Accelerometers were used to quantify arm movement for children with CP one week before, during, and 4+ weeks after CIMT and compared to typically-developing (TD) peers.

Design Observational during CIMT

Setting Clinical assessments and treatment occurred in a tertiary hospital and accelerometry data were collected in the community

Participants 7 children with CP (5m/2f, 7.4 ± 1.2 yrs) and 7 TD peers (2m/5f, 7.0 ± 2.3 yrs)

Intervention 30-hour CIMT protocol

Outcomes and Measures The use ratio, magnitude ratio, and bilateral magnitude were calculated from the accelerometry data. Clinical measures were evaluated before and after CIMT and surveys were used to assess the feasibility of using accelerometers.

Results Before CIMT, children with CP used their paretic arm less than their TD peers. During therapy, their frequency and magnitude of paretic arm use increased in the clinic and in daily life. After therapy, although clinical scores improved, children reverted to baseline accelerometry values. Additionally, children and parents in both cohorts had positive perceptions of wearing accelerometers.

Conclusions and Relevance The lack of sustained improved accelerometry metrics following CIMT suggest therapy gains did not translate to increased movement outside the clinic. Additional therapy may be needed to help the transfer of skills to the community setting.

What this Article Adds This study compares the movement of children with CP undergoing CIMT in the community setting with their typically developing peers. Additional interventions may be needed in combination with or following CIMT to sustain the benefits of the therapy outside of the clinic.

Copyright 
The copyright holder for this preprint is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. All rights reserved. No reuse allowed without permission.
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Posted June 11, 2019.
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Children with Cerebral Palsy Return to Baseline Community Arm Movement after Constraint Induced Movement Therapy
Brianna M. Goodwin, Emily K. Sabelhaus, Ying-Chun Pan, Kristie F. Bjornson, Kelly L. D. Pham, William O. Walker, Katherine M. Steele
bioRxiv 667246; doi: https://doi.org/10.1101/667246
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Children with Cerebral Palsy Return to Baseline Community Arm Movement after Constraint Induced Movement Therapy
Brianna M. Goodwin, Emily K. Sabelhaus, Ying-Chun Pan, Kristie F. Bjornson, Kelly L. D. Pham, William O. Walker, Katherine M. Steele
bioRxiv 667246; doi: https://doi.org/10.1101/667246

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