حرکت درمانی با محدودیت اجباری در بهبود عملکرد اندام فوقانی کودکان فلج مغزی همی‌پلژی اسپاستیک: مرور ادغام‌یافته و نظر خبرگان

نوع مقاله : مقاله مروری

نویسندگان

1 کمیته پژوهشی دانشجویان، دانشجوی کارشناسی ارشد کاردرمانی، دانشکده علوم توانبخشی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

2 استادیار گروه کاردرمانی، دانشکده علوم توانبخشی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

3 کارشناسی ارشد کاردرمانی و کارشناسی ارشد آموزش پزشکی، گروه کاردرمانی، دانشکده علوم توانبخشی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

چکیده

مقدمه و اهداف
حرکت­درمانی با محدودیت اجباری یکی از روش‌های موثر در بهبود عملکرد حرکتی اندام فوقانی کودکان فلج مغزی همی‌پلژی اسپاستیک است که انواع مختلفی دارد. هدف مطالعه مروری ادغام‌یافته حاضر، بررسی تاثیر محدودیت‌درمانی در کودکان با فلج مغزی همی‌پلژی اسپاستیک و ایجاد یک دستورالعمل مشخص برای استفاده‌ی این روش در این کودکان بود.
مواد و روش­‌ها
در مطالعه‌ی ترکیبی و دو مرحله‌ای حاضر، ابتدا در یک بررسی ادغام‌یافته سیستماتیک کلیه مقالات فارسی و انگلیسی بین سال‌های 2000 تا 2015 درباره‌ی حرکت­درمانی با محدودیت اجباری در کودکان فلج مغزی همی‌پلژی اسپاستیک با کلیدواژه‌های فلج مغزی، همی‌پلژی، حرکت­درمانی با محدودیت اجباری، توانبخشی و کاردرمانی استخراج و نتایج آن ثبت گردید. سپس در مرحله‌ی کیفی نتایج استخراج شده، در پانل خبرگان 5 نفره از کاردرمانگران حرفه‌ای در حوز‌ه‌ی فلج مغزی، مطرح و مورد بررسی قرار گرفت.
یافته‌ها
در بررسی انجام­شده 36 مقاله مرتبط با محدودیت‌درمانی در فلج مغزی و عملکرد اندام فوقانی یافت شد. ابتدا با بررسی خلاصه‌ی مقالات، تنها 14 مقاله که شرایط ورود به مطالعه را داشتند، انتخاب شدند. سپس متن کامل مقالات مرتبط با مداخلات در بهبود عملکرد دست بیماران فلج مغزی مورد بررسی قرار گرفت.
نتیج ه‌گیری
در بررسی‌های انجام­شده تاثیر مثبت حرکت­درمانی با محدودیت اجباری در بهبود عملکرد حرکتی کودکان فلج مغزی اثبات شده بود، ولی نتایج به شکل یک دستورالعمل مشخص نبوده؛ لذا با توجه به نظر خبرگان و متخصصین یک دستورالعمل مشخص برای این درمان تدوین شد. همچنین تاثیر این درمان با اسلینگ یا اسپیلنت به مدت 14 روز، روزی 6 ساعت همراه با مداخلات کاردرمانی و فیزیوتراپی بیشتر بود.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Constraint Induced Movement Therapy in Improving Upper Extremity Function in Children with Spastic Hemiplegia Cerebral Palsy: An Integrated Review and Experts’ View

نویسندگان [English]

  • Alireza Naddaf 1
  • Minoo Kalantari 2
  • Zahra Shafiee 3
1 Student Research Committee, MSc student of Occupational therapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Assistant Professor Department of Occupational Therapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 MSc of Occupational therapy & Medical education,S chool of Rehabilitation, Shahid Beheshti University Medical Sciences, Tehran, Iran
چکیده [English]

Background and Aims: Constraint Induced Movement Therapy (CIMT) is one of the effective methods in improving motor function of upper extremity in children with spastic hemiplegic cerebral palsy, which has various types. The objective of the present integrated review was to investigate the effect of CIMT in children with spastic hemiplegic cerebral palsy and to create specific instruction for using this method for these children.
Materials and Methods: In the present combined and two-stage study, first, in an integrated review, all articles in Persian and English languages between 2000 and 2015 on children with spastic hemiplegic cerebral palsy were extracted using the following keywords: cerebral palsy, hemiplegia, Constraint Induced Movement Therapy, rehabilitation, and occupational therapy. Then, in the qualitative stage, the results were examined in the five-member expert panel of professional occupational therapists in the area of cerebral palsy.
Results: In the conducted investigation, 36 articles were found related on cerebral palsy and upper extremity function. First, by examining the summary of articles, only 14 articles that met the inclusion criteria were selected. Then, full texts of articles related to interventions CIMT to improve hand function of patients with cerebral palsy were examined.
Conclusion: In the investigations conducted, the positive impact of CIMT in improving the motor function of children with cerebral palsy had been proven, but the results were not provided as an instruction. Therefore, with regard to the view of experts and specialists, a specific instruction for this treatment was developed. In addition, the impact of this treatment with a sling or splint for 14 days, 6 hours a day along with occupational therapy, and physiotherapy was more.

کلیدواژه‌ها [English]

  • Cerebral palsy
  • Hemiplegia
  • Constraint Induced Movement Therapy
  • Upper limb
  • occupational therapy
  • Rehabilitation
  1. Taub E, Uswatte G, Pidikiti R. Constraint-Induced Movement Therapy: a new family of techniques with broad application to physical rehabilitation--a clinical review. Journal of rehabilitation research and development. 1999;36(3):237.##
  2. Sung IY, Park JM. A pilot evaluation of cast immobilization of intact upper extremity: a new therapeutic approach for spastic hemiplegic cerebral palsy. Journal of Korean Academy of Rehabilitation Medicine. 1998;22(4):828-32. ##
  3. Krumlinde-sundholm L, Eliasson A-c. Development of the Assisting Hand Assessment: a Rasch-built measure intended for children with unilateral upper limb impairments. Scandinavian Journal of Occupational Therapy. 2003;10(1):16-26. ##
  4. Roberts CD, Vogtle L, Stevenson RD. Effect of hemiplegia on skeletal maturation. The Journal of pediatrics. 1994;125(5):824-8. ##
  5. Kuhtz-Buschbeck JP, Krumlinde Sundholm L, Eliasson A-C, Forssberg H. Quantitative assessment of mirror movements in children and adolescents with hemiplegic cerebral palsy. Developmental Medicine & Child Neurology. 2000;42(11):728-36. ##
  6. Boyd R, Morris M, Graham H. Management of upper limb dysfunction in children with cerebral palsy: a systematic review. European Journal of Neurology. 2001;8(s5):150-66. ##
  7. MJ NA, OG, AM, BH, JM, F, et al. The effects and maintainance of constraint-induced therapy onspasticity and function of upper extremity in hemiplegic cerebral palsy children 6 to 12 years old ( in Persian ). Modern Rehabilitation. 2010;4(3):41-7. ##
  8. Morris C. Definition and classification of cerebral palsy: a historical perspective. Developmental Medicine & Child Neurology. 2007;49(s109):3-7. ##
  9. Cope SM, Forst HC, Bibis D, Liu X-C. Modified constraint-induced movement therapy for a 12-month-old child with hemiplegia: a case report. American Journal of Occupational Therapy. 2008;62(4):430-7. ##

10. Rostami HR, Malamiri RA. Effect of treatment environment on modified constraint-induced movement therapy results in children with spastic hemiplegic cerebral palsy: a randomized controlled trial. Disability and rehabilitation. 2012;34(1):40-4. ##

11. Gilmore R, Ziviani J, Sakzewski L, Shields N, Boyd R. A balancing act: children's experience of modified constraint-induced movement therapy. Developmental neurorehabilitation. 2010;13(2):88-94. ##

12. Rassafiani M, Rezaee M. Effects of Constraint-Induced Movement Therapy (CIMT) on improvement of upper-limb and hand function in stroke patients: an integrative review. Rehabilitation Medicine. 2014;2(3):53-61. ##

13. Kwan J. Care pathways for acute stroke care and stroke rehabilitation: from theory to evidence. Journal of Clinical neuroscience. 2007;14(3):189-200. ##

14. Hoare BJ, Wasiak J, Imms C, Carey L. Constraint‐induced movement therapy in the treatment of the upper limb in children with hemiplegic cerebral palsy. The Cochrane Library. 2007. ##

15. Nik Ardakani MJ, Olyaei GR, Abdolvahab M, Bagheri H, Jalili M, Faghih Zadeh S. The effects and maintainance of constraint-induced therapy on spasticity and function of upper extremity in hemiplegic cerebral palsy children 6 to 12 years old. Journal of Modern Rehabilitation. 2010;4(3):41-7. ##

16. Sadegh hsm, Sourtiji h, Taghizadeh a. comparison of arm- hand bimanualintensive therapy and current therapy for unimanual and bimanual functions in children with cerebral palsy. scientific information database. 2011;7:525-32. ##

17. Huang H-h, Fetters L, Hale J, McBride A. Bound for success: a systematic review of constraint-induced movement therapy in children with cerebral palsy supports improved arm and hand use. Physical therapy. 2009;89(11):1126-41. ##

18. Cao J, Khan B, Hervey N, Tian F, Delgado MR, Clegg NJ, et al. Evaluation of cortical plasticity in children with cerebral palsy undergoing constraint-induced movement therapy based on functional near-infrared spectroscopy. Journal of biomedical optics. 2015;20(4):1-11. ##

19. Yu J, Kang H, Jung J. Effects of modified constraint-induced movement therapy on hand dexterity, grip strength and activities of daily living of children with cerebral palsy: a randomized control trial. Journal of Physical Therapy Science. 2012;24(10):1029-31. ##

20. Sakzewski L, Ziviani J, Abbott DF, Macdonell RA, Jackson GD, Boyd RN. Randomized trial of constraint‐induced movement therapy and bimanual training on activity outcomes for children with congenital hemiplegia. Developmental Medicine & Child Neurology. 2011;53(4):313-20. ##

21. Charles JR, Gordon AM. A repeated course of constraint‐induced movement therapy results in further improvement. Developmental Medicine & Child Neurology. 2007;49(10):770-3. ##

22. Eliasson AC, Krumlinde‐Sundholm L, Gordon AM, Feys H, Klingels K, Aarts P, et al. Guidelines for future research in constraint‐induced movement therapy for children with unilateral cerebral palsy: an expert consensus. Developmental Medicine & Child Neurology. 2014;56(2):125-37. ##

23. Fergus A, Buckler J, Farrell J, Isley M, McFarland M, Riley B. Constraint-induced movement therapy for a child with hemiparesis: a case report. Pediatric Physical Therapy. 2008;20(3):271-83. ##

24. Hoare BJ, Wasiak J, Imms C, Carey L. Constraint‐induced movement therapy in the treatment of the upper limb in children with hemiplegic cerebral palsy. The Cochrane Library. 2007(1):1-31. ##

25. Sung I-Y, Ryu J-S, Pyun S-B, Yoo S-D, Song W-H, Park M-J. Efficacy of forced-use therapy in hemiplegic cerebral palsy. Archives of physical medicine and rehabilitation. 2005;86(11):2195-8. ##

26. Dickerson AE, Brown LE. Pediatric constraint-induced movement therapy in a young child with minimal active arm movement. American Journal of Occupational Therapy. 2007;61(5):563-73. ##

27. Huang H-h, Fetters L, Hale J, McBride A. Bound for success: a systematic review of constraint-induced movement therapy in children with cerebral palsy supports improved arm and hand use. Physical Therapy. 2009. ##

28. Charles J, Lavinder G, Gordon AM. Effects of constraint-induced therapy on hand function in children with hemiplegic cerebral palsy. Pediatric Physical Therapy. 2001;13(2):68-76. ##

29. Kalantary M, Karimi E, Shafiee Z, Tabatabaiee SM. The effects of simultaneous use of task-oriented training and constraint-induced movement therapy on upper limb motor performance in hemiplegic adult patients. Journal of Research in Rehabilitation Sciences. 2013;9(2):253-65. ##