Meta-Analysis the Effect of Constraint-Induced Movement Therapy on Hands Functional Ability and Occupational Performance in Children with Cerebral Palsy
Abstract
Background: Children with cerebral palsy generally experience hand functional disorders which then affect the child's occupational performance. Hand functional ability is the ability to use the hand in doing activities. To be able to perform occupational performance, good hand functional abilities are needed. To achieve this, interventions are needed, one of which is constraint-induced movement therapy (CIMT) which is hypothesized to be able to improve hand functional ability and occupational per-formance. The purpose of this study was to determine the effect of CIMT on the hands functional ability and the occupation performance of children with cerebral palsy.
Subjects and Method: This study used a systematic review design and meta-analysis using the PRISMA flow chart guidelines. The process of searching for articles was carried out between 2005-2020 using databases from PubMed, Science Direct, AJOT, Springer Link, and Google Scholar. Based on the database, there were 20 articles that met the inclusion criteria. This study involved 669 subjects of hand functional ability and 440 subjects of occupational performance. The analysis was performed using the RevMan 5.3 software.
Results: A total of 20 articles conducted a meta-analysis review. A total of 18 articles conducted a meta-analysis showing that giving CIMT to children with cerebral palsy was significantly able to improve hands functional ability of children with cerebral palsy (SMD = 0.40; 95% CI 0.09 to 0.71; p = 0.01). A total of 11 articles conducted a meta-analysis showing that giving CIMT to children with cerebral palsy was able to improve occupational performance abilities but it was not statistically significant (SMD = 0.18; 95% CI 0.17 to 0.52; p = 0.32).
Conclusion: CIMT can improve hand functional abilities and occupational performance of children with cerebral palsy.
Keywords: constraint-induced movement therapy (CIMT), hand functional ability, occupational performance, cerebral palsy, meta-analysis
Correspondence: Mutiana Agustin Sholikah. Masters Program in Public Health. Universitas Sebelas Maret, Jl.Ir. Sutami 36A, Surakarta 57126, Jawa Tengah, Indonesia. Email: mutiana.ash@gmail.com. Mobile: 081215038686.
Journal of Epidemiology and Public Health (2021), 06(01): 1-11
References
Aarts PB, Jongerius PH, Geerdink YA, Limbeek JV, Geurts AC (2010). Effectiveness of modified constraint-induced movement therapy in children with unilateral spastic cerebral palsy: A randomized controlled trial. Neurorehabil Neural Repair. 24(6): 509
1177/15459683093-59767.
Al-Oraibi S, Eliasson AC (2011). Implementation of constraint-induced movement therapy for youngchildren with unilateral cerebral palsy in Jordan: A home-based model, Disabil Rehabil. 33(21
AOTA (2014). The occupational therapy practice framework: Domain process 3rd Edition, Am J Occup Ther. 68: 69
Arenz N, McCain K, Tjelta R (2017). There is moderate evidence that a low dose of CIMT (defined as 3 hours/day or less) is at least as effective as the traditional protocol involving 6 hours/day in improving upper extremity motor function in children with unilateral cerebral palsy. Available at: www.UWLAX.EDU/OT.
Brandao MdeB, Gordon AM, Mancini MC (2012). Functional impact of constraint therapy and bimanual training in children with cerebral palsy: A randomized controlled trial, Am J Occup Ther. 66(6): 672
Chen HC, Kang LJ, Chen CL, Lin KC, Chen FC, Wu KPH (2015). Younger children with cerebral palsy respond better than older ones to therapistbased constraint-induced therapy at home on functional outcomes and motor control, Phys Occup Ther Pediat. 36(2):1
Christmas PM, Sackley C, Feltham MG, Cummins C (2018). A randomized controlled trial to compare two methods of constraint-induced movement therapy to improve functional ability in the affected upper limb in preschool children with hemiplegic cerebralpalsy:
CATCH TRIAL, Clin Rehabil. 32(7): 909
Deluca SC, Case-Smith J, Stevenson R, Ramey SL (2012). Constraint-induced movement therapy (CIMT) for young children with cerebral palsy: Effects of therapeutic dosage, J Pediatr Rehabil Med, 5(2): 133
Duru
Eliasson AC, Holmefur M (2015). The influence of early modified constraint-induced movement therapy training on the longitudinal development of hand function in children with unilateral cerebral palsy. Dev Med Child Neurol. 57(1): 89
Gelkop N, Burshtein DG, Lahav A, Brezner A, Al-Oraibi S, Ferre CL, Gordon AM (2015). Efficacy of constraint-induced movement therapy and bimanual training in children with hemiplegic cerebral palsy in an educational setting, Phys Occup Ther Pediatr.35(1):
Gulati S, Sondhi V (2018). Cerebral Palsy: An Overview, Indian J Pediatr. 85(11): 1006
Ilieva E, Ilieva A (2020). What is the effect of constraint-induced movement therapy on children with unilateral cerebral palsy? A Cochrane Review summary with commentary. Dev Med Child Neurol. 62(11): 1236
Klevberg GL,
Levitt S, Addison A (2019). Treatment of Cerebral Palsy and Motor Delay. sixth edit. Hoboken. NJ: Wiley-Blackwell. doi: 10.1136/jnnp.61.1.121b.
Li G, Zeng J, Tian J, Levine MA, Thabane L (2020). Multiple uses of forest plots in presenting analysis results in health research. J Clin Epidemiol. 117: 89
Makowski D, Piraux F, Brun F (2019). From Experimental Network to Meta-analysis Methods and Applications with R for Agronomic and Environmental Sciences. France: Springer Nature B.V.
Miller F, Bachrach S, Lennon N, O
Murti B (2018). Prinsip dan Metode Riset Epidemiologi. edisi IV. Surakarta: Program Studi Ilmu Kesehatan Masyarakat, Program Pascasarjana, Universitas Sebelas Maret.
Sakzewski L, Miller L, Ziviani J, Abbott DF, Rose S, Macdonell RAL, Boyd RN (2015). Randomized comparison trial of density and context of upper limb intensive group versus individualized occupational therapy for children with unilateral cerebral palsy.
Dev Med Child Neurol. 57(6): 539
Simon-Martinez C, Mailleux L, Hoskens J, Ortibus E, Jaspers E, Wenderoth N, Sgandurra G, et al. (2020) Randomized controlled trial combining constraint-induced movement therapy and actionobservation training in unilateral cerebral palsy: clinical
effects and influencing factors of treatment respons. Ther Adv Neurol Disord. 13(1): 1
Wallen M, Ziviani J, Naylor O, Evans R, Novak I, Herbert R (2011). Modified constraint-induced therapy for child-ren with hemiplegic cerebral palsy: A randomized trial. Dev Med Child Neurol 53(12): 1091
