Developmental medicine and child neurology
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Dev Med Child Neurol · May 2015
Randomized Controlled TrialMotor endplate-targeted botulinum toxin injections of the gracilis muscle in children with cerebral palsy.
Intramuscular botulinum toxin-A (BoNT-A) injections reduce spasticity by blocking neurotransmission at the motor endplate (MEP). The goal of this study was to assess the reduction in spasticity achieved by injecting BoNT-A at different sites of the gracilis muscle. ⋯ The results suggest that BoNT-A injection of the gracilis at sites with a high concentration of MEPs is effective at reducing spasticity. These preliminary findings should be confirmed by larger studies. In the case of long muscles, such as the gracilis, the injection site is important.
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Dev Med Child Neurol · Mar 2013
Randomized Controlled Trial Comparative StudyIntensive therapy following upper limb botulinum toxin A injection in young children with unilateral cerebral palsy: a randomized trial.
Botulinum toxin A (BoNT-A) combined with occupational therapy is effective in improving upper limb outcomes in children with unilateral cerebral palsy (CP). It is now essential to identify the most effective therapies following BoNT-A. Given the added burden for children and families, the aim of this study was to explore whether modified constraint-induced movement therapy (mCIMT) leads to sufficiently superior gains compared with bimanual occupational therapy (BOT) in young children with unilateral CP following BoNT-A injections. ⋯ Following upper limb injection of BoNT-A, there was no evidence that mCIMT, despite the significantly increased intensity of the home programme, produced a superior effect across a range of outcomes compared with a structured programme of BOT in young children with unilateral CP.
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Dev Med Child Neurol · Dec 2011
Randomized Controlled Trial Comparative StudyModified constraint-induced therapy for children with hemiplegic cerebral palsy: a randomized trial.
Conventional constraint-based therapies are intensive and demanding to implement, particularly for children. Modified forms of constraint-based therapies that are family-centred may be more acceptable and feasible for families of children with cerebral palsy (CP)-but require rigorous evaluation using randomized trials. The aim of this study was to determine the effects of modified constraint-induced therapy compared with intensive occupational therapy on activities of daily living and upper limb outcomes in children with hemiplegic CP. ⋯ Modified constraint-induced therapy is no more effective than intensive occupational therapy for improving completion of activities of daily living or upper limb function in children with hemiplegic CP.
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Dev Med Child Neurol · Sep 2011
Randomized Controlled Trial Clinical TrialOral and non-oral sensorimotor interventions enhance oral feeding performance in preterm infants.
The aim of this study was to determine whether oral, tactile/kinaesthetic (T/K), or combined (oral+T/K) interventions enhance oral feeding performance and whether combined interventions have an additive/synergistic effect. ⋯ Oral and T/K interventions accelerated the transition from introduction to independent oral feeding and enhanced oral feeding skills. T/K has beneficial effects beyond the specific targeted system. The combined sensorimotor intervention led to an additive/synergistic effect for proficiency, further benefiting this population.
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Dev Med Child Neurol · Jul 2011
Randomized Controlled Trial Comparative StudyFocus on function: a cluster, randomized controlled trial comparing child- versus context-focused intervention for young children with cerebral palsy.
This study evaluated the efficacy of a child-focused versus context-focused intervention in improving performance of functional tasks and mobility in young children with cerebral palsy. ⋯ This study shows that child- or context-focused therapy approaches are equally effective and that frequency of intervention may be a critical component of successful intervention. Further evaluation is required to identify the various 'dose-response' relations of amount of treatment and changes in functional abilities.