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One Hand or Two for Children with Hemiplegia?: Effectiveness of Constraint Induced Movement Therapy (CIMT)

One Hand or Two for Children with Hemiplegia?: Effectiveness of Constraint Induced Movement Therapy (CIMT). Constraint of Non Hemiplegic Hand. Pat Burtner, PhD, OTR/L Department of Pediatrics, Division of Occupational Therapy John Phillips MD, Arvind Caprihan PhD

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One Hand or Two for Children with Hemiplegia?: Effectiveness of Constraint Induced Movement Therapy (CIMT)

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  1. One Hand or Two for Children with Hemiplegia?: Effectiveness of Constraint Induced Movement Therapy (CIMT) Constraint of Non Hemiplegic Hand Pat Burtner, PhD, OTR/L Department of Pediatrics, Division of Occupational Therapy John Phillips MD, Arvind Caprihan PhD Collaborators, MIND Institute Massed Practice Hemiplegic Hand (Play, Self Care) Impacting Developmental Disuse of Involved Extremity Intensive 2 week Intervention 4 hours /day

  2. Time fMRI fMRI CIMT Study 1: Effects of CIMT on Hand Function & Functional Skills (n=1) 3 Months Post 2 Immediate Post 1 Self Care Changes Pre Parent Identified Goals Grip Changes

  3. Study 2: Effects of CIMT Underlying Neural Mechanisms, Hand & Functional Skills (n=9) Significant ↑ EMG recruitment in Grip Significant ↑ Grip, Pinch ↓Timed Dexterity Significant ↓ EMG recruitment Timed Dexterity Preliminary analysis has revealed a possible relationship between of changes In Diffuse Tensor Imaging (DTI) Region of Interest and Grip Strength changes in 3 children receiving CIMT

  4. Study 3: Effects of Multiple Doses of CIMT on Hand Function and Functional Skills (n=1) 3 years 5 years 8 years Data Analysis In Progress Subject Constant Research Design Constant Measures Constant

  5. Study 4: Effect of Feedback on Motor Learning in Adults and Children (n=40) Katherine Sullivan PhD, PT, Collaborator Department of Biokinesiology and Physical Therapy, U.Southern California Early Late Practice Adult Child Adult (■) vs. Child (▲): 100% (solid) vs. 62% (open) Feedback on Acquisition & Retention

  6. Study 5: Effect of Feedback on Motor Learning in Children with Hemiplegia (n=40) Katherine Sullivan PhD, PT, Collaborator Department of Biokinesiology and Physical Therapy, University of Southern California 20 Children with Hemiplegic Cerebral Palsy (Use Non Hemiplegic Dominant Hand) 20 Control Children (Use Dominant Hand) 100% Feedback on all Trials • Hope to establish best practice effects for • children with cerebral palsy learning new motor skills • 2. Considering use of MRI brain lesion analysis with • subjects w/ CP to further understand cortical • contributions to motor learning

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