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DOI: 10.1055/s-0030-1252049
© Georg Thieme Verlag KG Stuttgart · New York
The Short-Term Effects of Combined Modified Constraint-Induced Movement Therapy and Botulinum Toxin Injection for Children with Spastic Hemiplegic Cerebral Palsy
Publikationsverlauf
received 23.08.2009
accepted 19.03.2010
Publikationsdatum:
05. Mai 2010 (online)
Abstract
Objective: The aim of this study was to investigate whether modified constraint-induced movement therapy (mCIMT) following a botulinum type A toxin (BoNT-A) injection enhances the effects of the BoNT-A injection into the spastic upper limb of children with hemiplegic cerebral palsy (CP).
Methods: A combined therapy with mCIMT and BoNT-A was given to 17 children in group A. Fifteen children in group B received only the BoNT-A injection. The muscle tone, the movement pattern, and the How Often and the How Well scales in the revised Pediatric Motor Activity Log (revised PMAL) were assessed before and 3 weeks after intervention.
Results: Three participants in group A dropped out due to poor tolerance of mCIMT. There were significant improvements in the muscle tone and the movement patterns for both groups (p<0.05), and the changes were not significantly different between the two groups. The How Often and the How Well scales in the revised PMAL were significantly improved in group A (p<0.05), but not in group B.
Conclusion: A combined therapy of mCIMT and BoNT-A seems to be helpful to enhance the effects of the BoNT-A injection in the functional use of the affected limb in children with hemiplegic CP.
Key words
cerebral palsy - hemiplegia - botulinum toxin - constraint-induced movement therapy - upper extremity
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Correspondence
Won Hyuk ChangMD, MS
Department of Physical
Medicine and Rehabilitation
Samsung Medical Center
Sungkyunkwan University
School of Medicine
50 Irwon-dong
Gangnam-gu
135-710 Seoul
Republic of Korea
Telefon: +82/2/3410 6068
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