Effects of combining constraint-induced movement therapy and action-observation training on upper limb kinematics in children with unilateral cerebral palsy : a randomized controlled trial

Simon‑Martinez, Cristina (University of Applied Sciences and Arts Western Switzerland (HES-SO Valais-Wallis) ; Department of Rehabilitation Sciences, Leuven, Belgium) ; Mailleux, Lisa (Department of Rehabilitation Sciences, Leuven, Belgium) ; Jaspers, Ellen (ETHZ, Zurich, Switzerland) ; Ortibus, Els (Department of Development and Regeneration, Leuven, Belgium) ; Desloovere, Kaat (Department of Rehabilitation Sciences, Leuven, Belgium ; University Hospitals Leuven, Belgium) ; Klingels, Katrijn (Department of Rehabilitation Sciences, Leuven, Belgium ; Hasselt University, Diepenbeek, Belgium) ; Feys, Hilde (Department of Rehabilitation Sciences, Leuven, Belgium)

Modified constraint-induced movement therapy (mCIMT) improves upper limb (UL) motor execution in unilateral cerebral palsy (uCP). As these children also show motor planning deficits, action-observation training (AOT) might be of additional value. Here, we investigated the combined value of AOT to mCIMT on UL kinematics in children with uCP in a randomized controlled trial. Thirty-six children with uCP completed an UL kinematic and clinical evaluation after participating in a 9-day mCIMT camp wearing a splint for 6 h/day. The experimental group (mCIMT + AOT, n = 20) received 15 h of AOT, i.e. video-observation and execution of unimanual tasks. The control group (mCIMT + placebo, n = 16) watched biological-motion free videos and executed the same tasks. We examined changes in motor control (movement duration, peak velocity, time-to-peak velocity, and trajectory straightness) and kinematic movement patterns (using Statistical Parametric Mapping) during the execution of three unimanual, relevant tasks before the intervention, after and at 6 months follow-up. Adding AOT to mCIMT mainly affected movement duration during reaching, whereas little benefit is seen on UL movement patterns. mCIMT, with or without AOT, improved peak velocity and trajectory straightness, and proximal movement patterns. Clinical and kinematic improvements are poorly related. Although there seem to be limited benefits of AOT to CIMT on UL kinematics, our results support the inclusion of kinematics to capture changes in motor control and movement patterns of the proximal joints.


Keywords:
Article Type:
scientifique
Faculty:
Economie et Services
School:
HEG-VS
Institute:
Institut Informatique de gestion
Subject(s):
Informatique
Date:
2020-10
Pagination:
15 p.
Published in:
Scientific reports
Numeration (vol. no.):
2020, vol. 10, article 10421, pp. 1-15
DOI:
ISSN:
2045-2322
Appears in Collection:



 Record created 2021-01-26, last modified 2021-01-29

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