"Remind to Move" Treatment Versus Constraint-induced Movement Therapy for Children With Hemiplegic Cerebral Palsy

The Hong Kong Polytechnic University

Status: Completed

Conditions: Upper Extremity Hemiplegia; Hemiplegic Cerebral Palsy

Treatments: Behavioral: Remind-to-move; Behavioral: Conventional rehabilitation; Behavioral: Modified constraint induced movement therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT02645331

HSEARS20130214003

Details and patient eligibility

About

The aim of this study was to determine the effects of an innovative child-friendly remind-to-move treatment (RTM) treatment by comparing it with constraint-induced movement therapy (CIMT) on upper extremity outcomes in children with hemiplegic Cerebral Palsy. In an evaluator-blinded randomized controlled trial, 73 children, among of whom 20 in Manual Ability Classification System level I, 38 level II, and 15 level III, were recruited from 3 special schools and randomized to receive 75-hour RTM (n=25) and CIMT (n=24) programme over 15-weekdays, and conventional treatment (n=24). The primary outcomes were Jebsen-Taylor Hand Function Test (JTHFT) and Bruininks-Oseretsky Test of Motor Proficiency (BOTMP-II) Subtest 3 for assessing the motor efficiency at baseline, posttest, and 1- and 3-month follow-up.

Enrollment: 73 patients

Sex: All

Ages: 5 to 16 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Diagnosis of Hemiplegic Cerebral Palsy
• Aged 5 to 16 years
• Ability to follow instructions
• Ability to grasp and release light objects, and at least 20° wrist and 10°fingers in metacarpophalangeal joints extension from full flexion for the affected hand
• Manual Activity Classification System (MACS) 19 grades I, II or III of the affected hand

Exclusion criteria

• Severe cognitive, visual, or auditory disorder
• Seizure and health problems not associated with cerebral palsy
• Predominant spasticity or contracture grades more than 3 of Modified Ashworth Scale 20 on wrist and finger flexors, forearm pronators and ⁄ or thumb adductors
• Receiving new pharmaceutical (i.e. botulinum toxin injections) and/or surgical interventions within 6-month before study

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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73 participants in 3 patient groups, including a placebo group

Remind-to-move

Experimental group

Description:

RTM involved a wristwatch device worn on more-affected arm which emitted sensory cueing continuously to remind the children to use the more-affected hand to engage in daily activities or complete bimanual tasks intensively, 5 hour per day, 5 days every week, for 3 consecutive weeks.

Treatment:

Behavioral: Remind-to-move

Modified constraint induced movement therapy (mCIMT)

Active Comparator group

Description:

children were encouraged to wear a customer-made volar resting splint that extended from below the elbow to the fingertips on their noninvolved hands for 5 hour daily except for toileting, writing and specific physical sports, for 3 weeks. Each child was supervised by one therapist to complete structured unimanual practice with the affected hand during the supervised session, 5 days every week, for 3 consecutive weeks.

Treatment:

Behavioral: Modified constraint induced movement therapy

Conventional rehabilitation

Placebo Comparator group

Description:

Conventional splinting, muscle strengthening, stretching, and neurodevelopmental facilitation techniques for 1hr daily, 2 day per week for 3 weeks.

Treatment:

Behavioral: Conventional rehabilitation