Article

The objective of this pilot study was to investigate the feasibility of constraint-induced movement therapy (CIMT) in children with obstetric brachial
plexus palsy and receive preliminary information about functional improvements.
Two patients (age 12 years) with obstetric brachial plexus palsy were included
for a 126-h home-based CIMT intervention (3 and 4.5 weeks) and weekly monitored
with the Melbourne Assessment of Unilateral Upper Limb function and the Nine-hole
Peg Test. The Assisted Hand Assessment was performed 3 weeks before the beginning
of intervention, preintervention, postintervention, and at 3 weeks follow-up (ABA
single-case design). Tests were analyzed descriptively, visually, and where
possible, using a time series analysis with C statistic. Results revealed changes
of arm function in both patients between preintervention and follow-up test as
follows: Assisted Hand Assessment from 85 to 92% in patient A and 80 to 89% in
patient B, in the Melbourne Assessment of Unilateral Upper Limb function from 87
to 90% (C=0.578, z=1.876, P<0.05) in patient A and 72 to 80% (C=0.827, z=2.68,
P<0.005) in patient B. There was no improvement in the Nine-hole Peg Test in both
patients. Improvements as a result of CIMT found in this pilot study may not be
considered substantial. However, they justify further research as some findings
indicate relationship to the CIMT intervention in the 'B' phase.
To enhance
motivation and to plan a controlled, randomized clinical trial, child-friendly
applications of the CIMT concept and adequate measures to monitor compliance are
being discussed.

Langue : ANGLAIS