Annals of Rehabilitation Medicine

Effects of the Constraint-Induced Movement Therapy on Cortical Reorganization in Patients with Hemiplegic Cerebral Palsy.: Lee, Zee Ihn , Byun, Seung Deuk , Chun, Kyung Ah; J Korean Acad Rehabil Med 2009;33(4):408-414.

Abstract
PDF

Objective
To investigate the effects of modified constraint- induced movement therapy (CIMT) on motor function and cortical activation in children with hemiplegic cerebral palsy (CP). Method: Five children with hemiplegic cerebral palsy were studied with Jebsen hand function test and quality of upper extremity skills test (QUEST), dynamic electromyography (EMG), and single photon emission computed tomography (SPECT) at rest before and after the CIMT period. Children were treated with a 4-week protocol of modified CIMT, consisting of twice-weekly 2-hour sessions of structured activities and a home program for non-treatment days. Children wore orthoses on their less affected upper extremities for 6 hours per day, during which time they were engaged in play, functional activities and 2-hour protocol of motor tasks. Results: Improvements in upper-extremity function were found in Jebsen hand function test and QUEST. Increased muscle activities in elbow extensors were observed in dynamic EMG during affected hand grip. In right hemiplegic patients, regional cerebral perfusion increased in right Brodmann area (BA) 3 and lentiform nucleus. In left hemiplegic patients, regional cerebral perfusion increased in right BA 6, 9, 21, left BA 19 and left cerebellum, but decreased in left BA 11. Conclusion: Modified CIMT appears to change local cerebral perfusion in areas known to participate in movement planning and execution. These changes might be a sign of cortical activation after CIMT in the children with hemiplegic cerebral palsy. Results of this study suggest that modified CIMT may be an effective way of treating children with hemiplegic CP. (J Korean Acad Rehab Med 2009; 33: 408-414)

2,106 View
14 Download

Leg Length Discrepancy in Children with Hemiplegic Cerebral Palsy.: Lee, Sool Ryon , Sung, In Young; J Korean Acad Rehabil Med 2003;27(6):850-854.

Abstract
PDF

Objective: The purpose of this study was to define the leg length discrepancy (LLD) in hemiplegic cerebral palsy compared with normal control group and to evaluate the contributing clinical factors to LLD.

Method: The study included 27 children with hemiplegic cerebral plasy and 12 normal control group who were taken Bell-Thomson's view x-ray for measuring of leg length. The patient group was divided into the group with LLD and the group without LLD. Then we evaluated the relationship between the rate of leg length shortening (LLS) and clinical factors.

Results: Of the total 27 cerebral palsy children, 18 children (66.7%) had LLD, whose average rate of LLS was 2.0 percent. Nine children didn't have LLD, whose average rate of LLS was 0.6 percent. There was no specific relationship between the rate of LLS and the age, muscle power or spasticity, but there was negative correlation between the rate of LLS and the score of gross motor functional measure (GMFM).

Conclusion: It is necessary to define the LLD in children with hemiplegic cerebral palsy by the rate of LLS and to be concerned about the LLD due to its possible correlation with poor functional outcome. (J Korean Acad Rehab Med 2003; 27: 850-854)

1,971 View
34 Download

A Pilot Evaluation of Cast Immobilization of Intact Upper Extremity: A New Therapeutic Approach for Spastic Hemiplegic Cerebral Palsy.: Sung, In Young , Park, Jun Min; J Korean Acad Rehabil Med 1998;22(4):828-832.

Abstract
PDF

Objective: To investigate the functional facilitation effect on an affected side of spastic hemiplegic cerebral palsy by immobilizing the intact side with a cast.

Method: Five hemiplegic cerebral palsies, who had been treated by general rehabilitation therapy during previous 6 months and showed no functional improvement were studied. Their intact arms were immobilized by scotch short arm casts for 6 weeks. And, the therapeatic effects of this method were evaluated by the Box and Block Test of manual dexterity, Erhardt Developmental Prehension Assesment and Brain Perfusion SPECT.

Results: 1. Box and Block test: Before the cast immobilization method, hemiplegic cerebral palsies could transfer a mean of 5.4⁑3.36 cubic rods from one to the other side, and after the treatment a mean of 8.0⁑1.41 cubic rods with the affected arm.

2. Erhardt Developmental Prehension Assesment: Before the treatment, the grasp motion of round rod, cubic rod, and button suited in a mean of 5.1⁑3.0 months, and after the treatment, suited in a mean of 8.2⁑0.66 months.

3. Brain Perfusion SPECTs did not change before and after the cast immobilization method.

4. There was no adverse effect resulting from the cast immobilization method on an intact side.

Conclusion: We concluded that the cast immobilization method on an intact side could be a new beneficial rehabilitation method for the treatment of spastic hemiplegic cerebral palsies.