Response from Authors
25
Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden. REFERENCES Basu, A, Eyre J. (2012). A plea for consideration of the less affected hand in therapeutic approaches to hemiplegia. Developmental Medicine and Child Neurology 54:380–382. Eliasson A-C, Krumlinde Sundholm L, Gordon AM, Feys H, Klingels K, Aarts PBM, et al. (2013). Guidelines for future research in constraint-induced movement therapy for children with unilateral cerebral palsy: an expert consensus. Developmental Medicine and Child Neurology. Advance online publication. doi: 10.1111/dmcn.12273. Eliasson A-C, Shaw K, Berg E, Krumlinde Sundholm L. (2011). An ecological approach of Constraint induced movement therapy for 2-3-year-old children: A randomized control trial. Research in Developmental Disabilities 32:2820–2828. Eyre JA, Taylor JP, Villagra F, Smith M, Miller S. (2001). Evidence of activity-dependent withdrawal of corticospinal projections during human development. Neurology 57:1543–1554. Greaves S, Imms C, Dodd K, Krumlinde Sundholm L. (2013). Development of the Mini-Assisting Hand Assessment: evidence for content and internal scale validity. Developmental Medicine and Child Neurology 55:1030–1037 Hoare B, Imms C, Villanueva E, Rawicki HB, Matyas T, Carey L. (2013). Intensive therapy following upper limb botulinum toxin A injection in young children with unilateral cerebral palsy: a randomized trial. Developmental Medicine & Child Neurology 55:238–247. Lowes LP, Mayhan M, Orr T, Batterson N, Tonneman JA, Meyer A, et al. (2013). Pilot Study of the Efficacy of Constraint-Induced Movement Therapy for Infants and Toddlers with Cerebral Palsy. Physical and Occupational Therapy in Pediatrics, Advance online publication. doi: 10.3109/01942638.2013.810186. Martin JH. (2012). Systems neurobiology of restorative neurology and future directions for repair of the damaged motor systems. Clinical Neurology and Neurosurgery 114:515–523. Wallen M, Ziviani J. (2013). Caution regarding the pediatric motor activity log to measure upper limb intervention outcomes for children with unilateral cerebral palsy. Developmental Medicine and Child Neurology 55:497–498.
Authors’ Response to Evidence to Practice Commentary Linda P Lowesa1,2 , Warren D Lo1,2 , Lindsay N Alfano1 , & Jane Case-Smith2 1
Nationwide Children’s Hospital, Columbus, Ohio, USA, 2 The Ohio State University, Columbus, Ohio, USA
In their Evidence to Practice Commentary, Hoare and Eliasson (2014) presented their concerns regarding our pilot study on the efficacy of constraint-induced DOI: 10.3109/01942638.2014.880260 Address Correspondence to: Dr. Linda P Lowes, Nationwide Children’s Hospital, 700 Children’s Dr, Columbus, OH 43205 USA (E-mail: [email protected]).
26
Lowes et al.
movement therapy for infants and toddlers with cerebral palsy (Lowes et al., 2014). Hoare and Eliasson refer to a consensus meeting convened to direct the future research on constraint-induced movement therapy for children with unilateral cerebral palsy (Eliasson et al., 2013). The summary addresses many critical factors such as the lack of appropriate outcome measures for infants and young children with hemiplegia. The commentators suggest a recently reported outcome measure that potentially may solve this deficiency (Greaves et al., 2013). We note that our study was completed prior to publication of the consensus meeting (Eliasson et al., 2013) and the measure by Greaves et al. which made incorporation of these new developments into our study impossible. We respond to Hoare and Eliasson’s concerns regarding: (1) our choice of outcome measures and (2) the potential for activitydependent withdrawal of corticospinal projections in relation to constraint of the less affected upper extremity. We agree wholeheartedly that the dearth of outcome measures for assessment of infant upper extremity function is a limitation in the field. To gather initial safety and efficacy data on a small group of infants, we decided to modify existing scales to determine as to what information could be gained. The Bayley Scales of Infant and Toddler Development—3rd edition (BSID-III) was our primary outcome measure based on its wide acceptance in the field and solid psychometric principles. Since the BSID-III has evaluative properties, although limited, we incorporated it in this pilot study since a superior option was not available at the time of study initiation (Spittle et al., 2008). Taken literally, the BSID-III scores represent the number of new skills that the infants achieved as a result of CIMT. The infants gained an average of four new skills during the intervention month compared to gaining two new skills in the baseline month, an improvement of 100%. Although these scores must be interpreted with caution given changes in sequence and item repetition, standardized procedures for administration and scoring were followed. The BSIDIII items have been well validated as reliable and meaningful when determining developmental levels. Prior studies, for example, Taub et al. (2004) and DeLuca et al, (2006) tallied newly emerged behaviors as an outcome of CIMT, reporting these behavioral counts as a meaningful measure of child change (Taub et al., 2004). We note that recent trials (Chen et al., 2013; Haynes & Phillips, 2012; Lin et al., 2011) used the Peabody Developmental Motor Scales, a developmental assessment similar to the BSID-III using similar methods to measure CIMT effects. To assist in the transparency and understanding the data collected, we presented both statistical analysis of the change in raw score and a visual trajectory of each infant’s performance at each evaluation. We also felt it important to gather information related to parents’ perception of change. Thus, we modified a widely used parent report measure, the Pediatric Movement Activity Log (PMAL). The PMAL has been used in at least five efficacy studies of CIMT. These studies found that the PMAL aligned with other standardized test results. Reliability and validity of the PMAL has been studied extensively (Hsin et al., 2012; Uswatte et al., 2012; Wallen et al., 2009). The PMAL-Revised has high internal consistency and test-retest reliability (Uswatte et al. 2012) along with moderate convergent validity (Uswatte et al., 2012). Wallen et al. (2009) found that the PMAL scores have strong test-retest reliability, and as evidence of construct validity, are associated with Manual Ability Classification System (MACS;
Response from Authors
27
Eliasson et al., 2006) levels. Hsin et al. (2012) found the PMAL to be responsive to change and suggested that 0.66 to 0.67 points (a benchmark all of the children in our study exceeded) represented the minimal clinically important change. We based the IMAL items directly on the PMAL items, and agree with Hoare and Eliasson that further study of the IMAL is needed. We also agree with Boyd and Sakzewski (2013) that psychometrically sound measures of parents’ perspectives are essential outcome variables for CIMT. We agree that human studies should consider evidence from relevant animal studies, in this case, blocking use of one limb during infancy. Martin and colleagues have performed extensive studies that are applicable to unilateral limb inactivation in infants (Friel et al., 2013, Friel et al., 2012, Chakrabarty et al., 2009). The work does not clearly illustrate that immobilization of a limb permanently affects appropriate termination of corticospinal (CS) tracts. This is an oversimplification of a model that involves muscimol suppression of M1 cortical activity. In this model, innervation from the cortex is suppressed, which may well alter trophic effects upon developing CS neurons. The experiments involving immobilization of a normal limb and then examining M1 cortical activity and CS termination have not yet been reported to our knowledge. Martin’s 2012 study (Friel et al., 2012) clearly shows that constraint plus training have important, beneficial effects upon re-establishment of the CS and recovery of skilled movement. In their recent review, Martin and colleagues (Friel et al., 2013) note that spinal interneuron development in the cat occurs at an age that corresponds to human ages 3–6 months, so timing of clinical interventions in humans is a variable that needs to be tested. Martin’s data also illustrate that suppression of M1 innervating the previously unaffected limb alternate inactivation is important in restoring normal CS projections for the initially affected limb (Chakrabarty et al., 2009). Our study’s rationale and hypotheses for use of constraint with infants were based on the principle that young children with hemiparesis acquire ”learned nonuse” or ”developmental disregard.” This well-documented principle posits that children ignore their more impaired upper extremity when they learn that they can efficiently use their unimpaired extremity. We hypothesized that early constraint can interrupt the disregard of the less efficient limb, enabling the child to establish a different trajectory for bimanual hand use. Although we saw the potential to disrupt ”developmental disregard” as documented by DeLuca et al. (2006), we also recognized the risk of casting for three weeks. Therefore, we carefully evaluated casting effects using BSID-III. The finding that the infants gained function in the casted extremity suggests that casting did no harm. We have continued to follow the five infants in this study; all have continued to make progress in bimanual skills. We agree that researchers must proceed carefully when evaluating an established intervention using modified procedures or with a younger population. When adapting standardized tools, psychometric properties need to be further established. For example, the recent adaptation of the Assisting Hand Assessment, the Mini-AHA, is currently undergoing studies of reliability and validity (Greaves et al, 2013). Consensus on most appropriate constraint and most efficient dosage have not been established, but are not in the scope of a pilot study. These questions need to be answered in adequately powered randomized trials. The purpose of our study was to test the feasibility of CIMT in infants and young children, and provide initial
28
Lowes et al.
data related to the safety, tolerability, and efficacy of the intervention. We submit that the changes in BSID-III raw scores, and parent-reported scores, along with qualitative improvements observed by both therapists and parents are sufficiently positive to warrant further consideration and investigation. We believe our study has stimulated needed discussion of the future direction of the field. Declaration of Interest: The authors report no conflict of interest. The authors alone are responsible for the content and writing of this article. ABOUT THE AUTHORS Linda Pax Lowes, PT, PhD, Clinical Therapies Research Director, Nationwide Children’s Hospital, Columbus Ohio, USA, 43205. Warren D Lo, MD, Neurologist, Nationwide Children’s Hospital, Columbus Ohio, USA, 43205. Lindsay N Alfano, PT, DPT, PCS, Nationwide Children’s Hospital, Columbus Ohio, USA, 43205. Jane Case-Smith, EdD OTR/L, Chair of Occupational Therapy Division, The Ohio State University, Columbus, Ohio 43210. REFERENCES Boyd RN, Sakzewski L, (2013). Assessment tools to measure upper-limb function and impact of therapy. In: Ramey S L, Coker-Bolt P, & DeLuca SC, eds. Handbook of pediatric constraintinduced movement therapy (CIMT). Bethesda, MO: AOTA Press, 89–112. Chakrabarty S, Friel KM, Martin JH. (2009). Activity-dependent plasticity improves M1 motor representation and corticospinal tract connectivity. Journal of Neurophysiology 101:1283–1293. Chen C, Kang L, Hong W-H, Chen F-C, Chen H-C,m & Wo C. (2013). Effect of therapist-based constraint-induced therapy at home on motor control, motor performance and daily function in children with cerebral palsy: A randomized controlled study. Clinical Rehabilitation 27, 236–245. DeLuca SC, Echols K, Law CR, & Ramey SL. (2006). Intensive pediatric constraint-induced therapy for children with cerebral palsy. Journal of Child Neurology 21:931–938. Eliasson A-C, Krumlinde-Sundholm L, Gordon A, Feys H, Klingels K, Aarts P, et al. (2013). Guidelines for future research in constraint-induced movement therapy for children with unilateral cerebral palsy: An expert consensus. Developmental Medicine and Child Neurology, epub ahead of print. DOI: 10.1111/dmcn.12273 Eliasson AC, Krumlinde-Sundholm L, Rosblad B, Beckung E, Amer M, Ohrvall AM, et al. (2006). The Manual ability classification system (MACS) for children with cerebral palsy: Scale development and evidence of validity and reliability. Developmental Medicine and Child Neurology 48:549–554. Friel K, Chakrabarty S, Kuo HC, Martin J. (2012). Using motor behavior during an early critical period to restore skilled limb movement after damage to the corticospinal system during development. Journal of Neuroscience 32:9265–9276. Friel KM, Chakrabarty S, Martin JH. (2013). Pathophysiological mechanisms of impaired limb use and repair strategies for motor systems after unilateral injury of the developing brain. Developmental Medicine and Child Neurology 55:27–31. Greaves S, Imms C, Dodd K, Krumlinde Sundholm L. (2013). Development of the mini-assisting hand assessment: Evidence for content and internal scale validity. Developmental Medicine and Child Neurology 55:1030–1037. Haynes MP, Phillips D. (2012). Modified constraint induced movement therapy enhanced by a neuro-development treatment-based therapeutic handling protocol: Two case studies. Journal of Pediatric Rehabilitation Medicine 5:117–124.
Response from Authors
29
Hoare B, Eliasson A-C. (2014). Evidence to practice commentary: Upper limb constraint in infants: Important perspectives on measurement and the potential for activity-dependent withdrawal of corticospinal projections. Physical & Occupational Therapy in Pediatrics 34:2013. Hsin T, Chen F-C, Lin K, Kange L, Chen C, Chen C. (2012). Efficacy of constraint-induced therapy on functional performance and health-related quality of life for children with cerebral palsy: A randomized controlled trial. Journal of Child Neurology 27:992–999. Lin K, Want T, Wu C, Chen C, Chang K, Lin Y, Chen Y. (2011). Effects of home-based constraint-induced therapy versus dose-matched control intervention on functional outcomes and caregiver well-being in children with cerebral palsy. Research in Developmental Disabilities 32:1483–1491. Lowes LP, Mayhan M, Orr T, Batterson N, Tonneman JA, Meyer A, et al. (2014). Pilot study of the efficacy of constraint-induced movement therapy for infants and toddlers with cerebral palsy. Physical & Occupational Therapy in Pediatrics, 34. Spittle AJ, Doyle LW, Boyd RN. (2008). A systematic review of the clinimetric properties of neuromotor assessments for preterm infants during the first year of life. Developmental Medicine and Child Neurology 50:254–266. Taube E, Ramey SL, DeLuca SD, Echols K. (2004). Efficacy of constraint-induced movement therapy for children with cerebral palsy with asymmetric motor impairment. Pediatrics 113:305–312. Uswatte G, Taub E, Griffin A, Vogtle L, Rowe J, Barman J. (2012). The pediatric motor activity log-revised: Assessing real-world arm use in children with cerebral palsy. Rehabilitation Psychology 57:149–158. Wallen M, Bundy A, Pont K, Ziviani J. (2009). Psychometric properties of the pediatric motor activity log used for children with cerebral palsy. Developmental Medicine and Child Neurology 51:200–208.
Copyright of Physical & Occupational Therapy in Pediatrics is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
25
Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden. REFERENCES Basu, A, Eyre J. (2012). A plea for consideration of the less affected hand in therapeutic approaches to hemiplegia. Developmental Medicine and Child Neurology 54:380–382. Eliasson A-C, Krumlinde Sundholm L, Gordon AM, Feys H, Klingels K, Aarts PBM, et al. (2013). Guidelines for future research in constraint-induced movement therapy for children with unilateral cerebral palsy: an expert consensus. Developmental Medicine and Child Neurology. Advance online publication. doi: 10.1111/dmcn.12273. Eliasson A-C, Shaw K, Berg E, Krumlinde Sundholm L. (2011). An ecological approach of Constraint induced movement therapy for 2-3-year-old children: A randomized control trial. Research in Developmental Disabilities 32:2820–2828. Eyre JA, Taylor JP, Villagra F, Smith M, Miller S. (2001). Evidence of activity-dependent withdrawal of corticospinal projections during human development. Neurology 57:1543–1554. Greaves S, Imms C, Dodd K, Krumlinde Sundholm L. (2013). Development of the Mini-Assisting Hand Assessment: evidence for content and internal scale validity. Developmental Medicine and Child Neurology 55:1030–1037 Hoare B, Imms C, Villanueva E, Rawicki HB, Matyas T, Carey L. (2013). Intensive therapy following upper limb botulinum toxin A injection in young children with unilateral cerebral palsy: a randomized trial. Developmental Medicine & Child Neurology 55:238–247. Lowes LP, Mayhan M, Orr T, Batterson N, Tonneman JA, Meyer A, et al. (2013). Pilot Study of the Efficacy of Constraint-Induced Movement Therapy for Infants and Toddlers with Cerebral Palsy. Physical and Occupational Therapy in Pediatrics, Advance online publication. doi: 10.3109/01942638.2013.810186. Martin JH. (2012). Systems neurobiology of restorative neurology and future directions for repair of the damaged motor systems. Clinical Neurology and Neurosurgery 114:515–523. Wallen M, Ziviani J. (2013). Caution regarding the pediatric motor activity log to measure upper limb intervention outcomes for children with unilateral cerebral palsy. Developmental Medicine and Child Neurology 55:497–498.
Authors’ Response to Evidence to Practice Commentary Linda P Lowesa1,2 , Warren D Lo1,2 , Lindsay N Alfano1 , & Jane Case-Smith2 1
Nationwide Children’s Hospital, Columbus, Ohio, USA, 2 The Ohio State University, Columbus, Ohio, USA
In their Evidence to Practice Commentary, Hoare and Eliasson (2014) presented their concerns regarding our pilot study on the efficacy of constraint-induced DOI: 10.3109/01942638.2014.880260 Address Correspondence to: Dr. Linda P Lowes, Nationwide Children’s Hospital, 700 Children’s Dr, Columbus, OH 43205 USA (E-mail: [email protected]).
26
Lowes et al.
movement therapy for infants and toddlers with cerebral palsy (Lowes et al., 2014). Hoare and Eliasson refer to a consensus meeting convened to direct the future research on constraint-induced movement therapy for children with unilateral cerebral palsy (Eliasson et al., 2013). The summary addresses many critical factors such as the lack of appropriate outcome measures for infants and young children with hemiplegia. The commentators suggest a recently reported outcome measure that potentially may solve this deficiency (Greaves et al., 2013). We note that our study was completed prior to publication of the consensus meeting (Eliasson et al., 2013) and the measure by Greaves et al. which made incorporation of these new developments into our study impossible. We respond to Hoare and Eliasson’s concerns regarding: (1) our choice of outcome measures and (2) the potential for activitydependent withdrawal of corticospinal projections in relation to constraint of the less affected upper extremity. We agree wholeheartedly that the dearth of outcome measures for assessment of infant upper extremity function is a limitation in the field. To gather initial safety and efficacy data on a small group of infants, we decided to modify existing scales to determine as to what information could be gained. The Bayley Scales of Infant and Toddler Development—3rd edition (BSID-III) was our primary outcome measure based on its wide acceptance in the field and solid psychometric principles. Since the BSID-III has evaluative properties, although limited, we incorporated it in this pilot study since a superior option was not available at the time of study initiation (Spittle et al., 2008). Taken literally, the BSID-III scores represent the number of new skills that the infants achieved as a result of CIMT. The infants gained an average of four new skills during the intervention month compared to gaining two new skills in the baseline month, an improvement of 100%. Although these scores must be interpreted with caution given changes in sequence and item repetition, standardized procedures for administration and scoring were followed. The BSIDIII items have been well validated as reliable and meaningful when determining developmental levels. Prior studies, for example, Taub et al. (2004) and DeLuca et al, (2006) tallied newly emerged behaviors as an outcome of CIMT, reporting these behavioral counts as a meaningful measure of child change (Taub et al., 2004). We note that recent trials (Chen et al., 2013; Haynes & Phillips, 2012; Lin et al., 2011) used the Peabody Developmental Motor Scales, a developmental assessment similar to the BSID-III using similar methods to measure CIMT effects. To assist in the transparency and understanding the data collected, we presented both statistical analysis of the change in raw score and a visual trajectory of each infant’s performance at each evaluation. We also felt it important to gather information related to parents’ perception of change. Thus, we modified a widely used parent report measure, the Pediatric Movement Activity Log (PMAL). The PMAL has been used in at least five efficacy studies of CIMT. These studies found that the PMAL aligned with other standardized test results. Reliability and validity of the PMAL has been studied extensively (Hsin et al., 2012; Uswatte et al., 2012; Wallen et al., 2009). The PMAL-Revised has high internal consistency and test-retest reliability (Uswatte et al. 2012) along with moderate convergent validity (Uswatte et al., 2012). Wallen et al. (2009) found that the PMAL scores have strong test-retest reliability, and as evidence of construct validity, are associated with Manual Ability Classification System (MACS;
Response from Authors
27
Eliasson et al., 2006) levels. Hsin et al. (2012) found the PMAL to be responsive to change and suggested that 0.66 to 0.67 points (a benchmark all of the children in our study exceeded) represented the minimal clinically important change. We based the IMAL items directly on the PMAL items, and agree with Hoare and Eliasson that further study of the IMAL is needed. We also agree with Boyd and Sakzewski (2013) that psychometrically sound measures of parents’ perspectives are essential outcome variables for CIMT. We agree that human studies should consider evidence from relevant animal studies, in this case, blocking use of one limb during infancy. Martin and colleagues have performed extensive studies that are applicable to unilateral limb inactivation in infants (Friel et al., 2013, Friel et al., 2012, Chakrabarty et al., 2009). The work does not clearly illustrate that immobilization of a limb permanently affects appropriate termination of corticospinal (CS) tracts. This is an oversimplification of a model that involves muscimol suppression of M1 cortical activity. In this model, innervation from the cortex is suppressed, which may well alter trophic effects upon developing CS neurons. The experiments involving immobilization of a normal limb and then examining M1 cortical activity and CS termination have not yet been reported to our knowledge. Martin’s 2012 study (Friel et al., 2012) clearly shows that constraint plus training have important, beneficial effects upon re-establishment of the CS and recovery of skilled movement. In their recent review, Martin and colleagues (Friel et al., 2013) note that spinal interneuron development in the cat occurs at an age that corresponds to human ages 3–6 months, so timing of clinical interventions in humans is a variable that needs to be tested. Martin’s data also illustrate that suppression of M1 innervating the previously unaffected limb alternate inactivation is important in restoring normal CS projections for the initially affected limb (Chakrabarty et al., 2009). Our study’s rationale and hypotheses for use of constraint with infants were based on the principle that young children with hemiparesis acquire ”learned nonuse” or ”developmental disregard.” This well-documented principle posits that children ignore their more impaired upper extremity when they learn that they can efficiently use their unimpaired extremity. We hypothesized that early constraint can interrupt the disregard of the less efficient limb, enabling the child to establish a different trajectory for bimanual hand use. Although we saw the potential to disrupt ”developmental disregard” as documented by DeLuca et al. (2006), we also recognized the risk of casting for three weeks. Therefore, we carefully evaluated casting effects using BSID-III. The finding that the infants gained function in the casted extremity suggests that casting did no harm. We have continued to follow the five infants in this study; all have continued to make progress in bimanual skills. We agree that researchers must proceed carefully when evaluating an established intervention using modified procedures or with a younger population. When adapting standardized tools, psychometric properties need to be further established. For example, the recent adaptation of the Assisting Hand Assessment, the Mini-AHA, is currently undergoing studies of reliability and validity (Greaves et al, 2013). Consensus on most appropriate constraint and most efficient dosage have not been established, but are not in the scope of a pilot study. These questions need to be answered in adequately powered randomized trials. The purpose of our study was to test the feasibility of CIMT in infants and young children, and provide initial
28
Lowes et al.
data related to the safety, tolerability, and efficacy of the intervention. We submit that the changes in BSID-III raw scores, and parent-reported scores, along with qualitative improvements observed by both therapists and parents are sufficiently positive to warrant further consideration and investigation. We believe our study has stimulated needed discussion of the future direction of the field. Declaration of Interest: The authors report no conflict of interest. The authors alone are responsible for the content and writing of this article. ABOUT THE AUTHORS Linda Pax Lowes, PT, PhD, Clinical Therapies Research Director, Nationwide Children’s Hospital, Columbus Ohio, USA, 43205. Warren D Lo, MD, Neurologist, Nationwide Children’s Hospital, Columbus Ohio, USA, 43205. Lindsay N Alfano, PT, DPT, PCS, Nationwide Children’s Hospital, Columbus Ohio, USA, 43205. Jane Case-Smith, EdD OTR/L, Chair of Occupational Therapy Division, The Ohio State University, Columbus, Ohio 43210. REFERENCES Boyd RN, Sakzewski L, (2013). Assessment tools to measure upper-limb function and impact of therapy. In: Ramey S L, Coker-Bolt P, & DeLuca SC, eds. Handbook of pediatric constraintinduced movement therapy (CIMT). Bethesda, MO: AOTA Press, 89–112. Chakrabarty S, Friel KM, Martin JH. (2009). Activity-dependent plasticity improves M1 motor representation and corticospinal tract connectivity. Journal of Neurophysiology 101:1283–1293. Chen C, Kang L, Hong W-H, Chen F-C, Chen H-C,m & Wo C. (2013). Effect of therapist-based constraint-induced therapy at home on motor control, motor performance and daily function in children with cerebral palsy: A randomized controlled study. Clinical Rehabilitation 27, 236–245. DeLuca SC, Echols K, Law CR, & Ramey SL. (2006). Intensive pediatric constraint-induced therapy for children with cerebral palsy. Journal of Child Neurology 21:931–938. Eliasson A-C, Krumlinde-Sundholm L, Gordon A, Feys H, Klingels K, Aarts P, et al. (2013). Guidelines for future research in constraint-induced movement therapy for children with unilateral cerebral palsy: An expert consensus. Developmental Medicine and Child Neurology, epub ahead of print. DOI: 10.1111/dmcn.12273 Eliasson AC, Krumlinde-Sundholm L, Rosblad B, Beckung E, Amer M, Ohrvall AM, et al. (2006). The Manual ability classification system (MACS) for children with cerebral palsy: Scale development and evidence of validity and reliability. Developmental Medicine and Child Neurology 48:549–554. Friel K, Chakrabarty S, Kuo HC, Martin J. (2012). Using motor behavior during an early critical period to restore skilled limb movement after damage to the corticospinal system during development. Journal of Neuroscience 32:9265–9276. Friel KM, Chakrabarty S, Martin JH. (2013). Pathophysiological mechanisms of impaired limb use and repair strategies for motor systems after unilateral injury of the developing brain. Developmental Medicine and Child Neurology 55:27–31. Greaves S, Imms C, Dodd K, Krumlinde Sundholm L. (2013). Development of the mini-assisting hand assessment: Evidence for content and internal scale validity. Developmental Medicine and Child Neurology 55:1030–1037. Haynes MP, Phillips D. (2012). Modified constraint induced movement therapy enhanced by a neuro-development treatment-based therapeutic handling protocol: Two case studies. Journal of Pediatric Rehabilitation Medicine 5:117–124.
Response from Authors
29
Hoare B, Eliasson A-C. (2014). Evidence to practice commentary: Upper limb constraint in infants: Important perspectives on measurement and the potential for activity-dependent withdrawal of corticospinal projections. Physical & Occupational Therapy in Pediatrics 34:2013. Hsin T, Chen F-C, Lin K, Kange L, Chen C, Chen C. (2012). Efficacy of constraint-induced therapy on functional performance and health-related quality of life for children with cerebral palsy: A randomized controlled trial. Journal of Child Neurology 27:992–999. Lin K, Want T, Wu C, Chen C, Chang K, Lin Y, Chen Y. (2011). Effects of home-based constraint-induced therapy versus dose-matched control intervention on functional outcomes and caregiver well-being in children with cerebral palsy. Research in Developmental Disabilities 32:1483–1491. Lowes LP, Mayhan M, Orr T, Batterson N, Tonneman JA, Meyer A, et al. (2014). Pilot study of the efficacy of constraint-induced movement therapy for infants and toddlers with cerebral palsy. Physical & Occupational Therapy in Pediatrics, 34. Spittle AJ, Doyle LW, Boyd RN. (2008). A systematic review of the clinimetric properties of neuromotor assessments for preterm infants during the first year of life. Developmental Medicine and Child Neurology 50:254–266. Taube E, Ramey SL, DeLuca SD, Echols K. (2004). Efficacy of constraint-induced movement therapy for children with cerebral palsy with asymmetric motor impairment. Pediatrics 113:305–312. Uswatte G, Taub E, Griffin A, Vogtle L, Rowe J, Barman J. (2012). The pediatric motor activity log-revised: Assessing real-world arm use in children with cerebral palsy. Rehabilitation Psychology 57:149–158. Wallen M, Bundy A, Pont K, Ziviani J. (2009). Psychometric properties of the pediatric motor activity log used for children with cerebral palsy. Developmental Medicine and Child Neurology 51:200–208.
Copyright of Physical & Occupational Therapy in Pediatrics is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
