This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Scopus Google Scholar Articles by Sutcliffe, T. L. Articles by Fehlings, D. L. PubMed PubMed Citation Articles by Sutcliffe, T. L. Articles by Fehlings, D. L. Social Bookmarking                         What's this?

Pediatric Constraint-Induced Movement Therapy Is Associated With Increased Contralateral Cortical Activity on Functional Magnetic Resonance Imaging

Department of Pediatrics, Stanford University School of Medicine, Stanford, California

William J. Logan, MD, FRCPC

Department of Pediatrics, University of Toronto Faculty of Medicine, Hospital for Sick Children, Toronto, Canada

Darcy L. Fehlings, MD, MSc, FRCPC

Department of Pediatrics, University of Toronto Faculty of Medicine, Hospital for Sick Children, Toronto, Canada, Bloorview Research Institute, Bloorview Kids Rehab, Toronto, Canada, dfehlings{at}bloorview.ca

The mechanism behind constraint-induced movement therapy (constraint therapy) success is unknown. Study objectives were to evaluate cortical change after modified constraint therapy and explore a novel approach to quantify developmental disregard. Five participants underwent modified constraint therapy. Functional magnetic resonance imaging (MRI) and clinical measures were done pretreatment and posttreatment. Developmental disregard indices were calculated. Four participants showed clinical improvement posttreatment. Functional MRI laterality indices were variable pretreatment and exclusively contralateral among participants posttreatment. The disregard index range was —12.9 to 62.6 among participants. Disregard indices were correlated with change scores after treatment on the Pediatric Motor Activity Log amount of use domain (r = .93, P = .02), Assisting Hand Assessment (r = .93, P = .02), and grip strength (r = .92, P = .03). Study results suggest that a shift to or persistence of contralateral cortical activity for affected hand movement is important for constraint therapy mechanism of action; and developmental disregard may be a predictor of positive response to treatment.

Key Words: constraint-induced movement therapy • cerebral palsy • functional MRI • developmental disregard

Journal of Child Neurology, Vol. 24, No. 10, 1230-1235 (2009)
DOI: 10.1177/0883073809341268


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?