Movement Therapy Research Articles

Current knowledge and practice of post-stroke unilateral spatial neglect rehabilitation: a national survey of Nigerian physiotherapists

BackgroundUnilateral spatial neglect (USN) is a leading cause of disability and handicap in stroke survivors affecting functional recovery. Therapists’ knowledge and practice in post-stroke unilateral spatial neglect are key to the success of rehabilitation.AimThis study aimed to evaluate physiotherapists’ knowledge of USN and the current practice of USN management.MethodA cross-sectional study was undertaken among Nigerian physiotherapists (N = 240). An online structured questionnaire that assessed respondents’ knowledge, current practice, barriers, and enablers to post-stroke USN rehabilitation was administered.ResultsThe total knowledge score was 12.6 ± 4.75 on a scale of 25. Few physiotherapists (7.92%) demonstrated good knowledge of USN. Postgraduate certification (p = 0.001), clinical practice setting (p = 0.008), and working full time in neurorehabilitation (p = 0.033) were significantly associated with the therapist’s knowledge of USN. There was a nonsignificant positive correlation between the duration of practice in the neurorehabilitation setting (r = 0.02; p = 0.854) and USN knowledge. A nonsignificant minimal negative correlation between practice as a physiotherapist (r = − 0.02; p = 0.772) and USN knowledge was also noted. The age of physiotherapists showed no linear relationship with the therapist’s knowledge of USN (r = − 0.00; p = 0.992). Constraint-induced movement therapy (86.47%) was the most commonly used USN treatment, while Albert’s test (49.37%) was the most utilized screening tool for USN.ConclusionsVery few physiotherapists had good knowledge of USN. Participants’ knowledge increased as they attained higher education levels relating to neurological physiotherapy. These findings emphasize the need for specialist rehabilitation training for physiotherapy practice.

An Able-Bodied Study for Potential Usage of a Knee Scooter as a Constraint-Induced Movement Therapy (CIMT) Gait Training Device.

Post-stroke gait is characterized by slow and asymmetrical hemiparetic gait. This is attributed to the paretic lower limb which has limited plantar propulsion. The most effective method to restore paretic limb function is constraint-induced movement therapy (CIMT), which promotes the usage of the paretic limb by restricting the movement of the unafflicted limb. However, due to the necessity of both lower limbs to perform gait, CIMT methods could not be directly applied for gait rehabilitation. In this study, we explore the feasibility of utilizing a knee scooter as a means to facilitate CIMT gait training. We hypothesize that if lower limb kinematics and muscle activation patterns during gait with a knee scooter match that of natural gait, the knee scooter could be utilized for CIMT gait training. We measured the lower-limb joint angles, plantar force, EMG patterns, stride length, and step times of 13 healthy subjects during gait with a knee scooter and natural gait. The results suggest that the gait patterns while using the knee scooter closely resemble those of natural gait.

Non-pharmacological interventions on quality of life in stroke survivors: A systematic review and meta-analysis.

Non-pharmacological interventions have been used in the rehabilitation of stroke survivors, but their effects on stroke survivors' quality of life (QoL) are unknown. This review aimed to summarize the existing evidence regarding non-pharmacological interventions for QoL in stroke survivors and to evaluate the effectiveness of different types of interventions. We systematically searched databases including PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Chinese BioMedical Literature Database, China Science and Technology Journal Database, and Wanfang data from the earliest available records to March 2023. Randomized controlled trials which explored the effects of non-pharmacological interventions on QoL in stroke patients were included. The meta-analysis was conducted to evaluate the effectiveness of different interventions on QoL. The Review Manager 5.3 was used to conduct the meta-analysis and the revised Cochrane risk-of-bias tool was used to assess the methodological quality of trials. A total of 93,245 records were identified, and 34 articles were reviewed and summarized, of which 20 articles were included in the meta-analysis. The summary of the findings of the included studies revealed fitness training, constraint-induced movement therapy (CIMT), physical exercise, music therapy (MT), and art-based interventions may have positive effects on QoL. The fitness training improved total QoL, especially in physical domains including physical functioning (mean difference [MD] = 10.90; 95% CI [7.20, 14.59]), role physical (MD = 10.63; 95% CI [6.71, 14.55]), and global health (MD = 8.76; 95% CI [5.14, 12.38]). The CIMT had a slight effect on general QoL (standardized mean difference [SMD] = 0.48, 95% CI [0.16, 0.80]), whereas significantly improved strength (MD = 8.84; 95% CI [1.31, 16.38]), activities of daily living/instrumental activities of daily living (ADL/IADL; MD = 10.42; 95% CI [2.98, 17.87]), and mobility (MD = 8.02; 95% CI [1.21, 14.83]). MT had a positive effect on the mental health domain (SMD = 0.54; 95% CI [0.14, 0.94]). Our findings suggest that fitness training and CIMThave a significant effect on improving physical QoL, while MThas a positive effect on improving psychological QoL. Future studies may use comprehensive and multicomponent interventions to simultaneously improve the patients' physical, psychological, and social QoL.

Effectiveness of Modified Constraint Induced Movement Therapy in Improving Functional Activities of Hand in Sub Acute Stroke Subjects

BACKGROUND: In stroke, upper limb hemi paresis is a commonly seen impairment and challenging for activities of daily living that have a significant impact on one's quality of life. The majority of studies used both occupational therapy and physiotherapy to improve hand functions in subjects who had chronic strokes. Stroke patients often under-utilizes their paretic limb despite sufficient residual motor function. We hypothesize that acquired non-use can be overcome by reinforcement-based training strategies. The goal of this study is to analyze the efficacy of modified constraint induced movement therapy (m CIMT), to improve functional activities of hand in sub acute Stroke subjects. AIM: The Objective of this study was to analyze the effectiveness of Modified constraint induced movement therapy in improving hand functions in Sub acute stroke subjects. Methodology: This study was an Experimental study and the type of sampling was convenient sampling. The sample size was 30 subjects with unilateral hemiplegia with duration of more than 3 months and the study was conducted in outpatient PT Department. Results: The results were obtained using FMA and MAL on the basis of Pre and Post treatment data and comparing the Control and experimental groups. The statistical analysis showed significant difference between the experimental group and the control group. This shows that subjects in the experimental group who received Modified Constraint induced movement therapy have shown significant improvement than control Group who received only Conventional Physiotherapy. Conclusion: Modified constraint induced movement therapy can be added in stroke rehabilitation for improvement of activities of daily living and functional independence of stroke patients. Keywords: Hemi paresis, CIMT, m CIMT

Interdisciplinary pain therapy in the elderly

Chronic pain in the elderly is becoming increasingly important and is associated with serious health impacts. Therefore, international guidelines demand that pain therapy for the elderly preferably be amultimodal therapy based on abio-psycho-social pain model. Specific psychometric tests and interview guidelines are available for the interdisciplinary pain assessment. Evidence for the effectiveness of multimodal pain therapy in the elderly remains limited. However, controlled clinical trials have shown that these patients benefit-especially if the intervention is adapted to their specific needs. The focus of movement therapy is not only muscle strengthening but also coordination exercises. In individual physical therapy and occupational therapy, everyday solutions can be developed for individual physical limitations that are more frequent in old age. In psychological training, pain acceptance, balancing rest and activity, social integration and dealing with aging are particularly important topics. Relaxation and mindfulness techniques can also favorably affect pain and function. Thus, these are popular with patients and are often adopted in everyday pain management. Pain education is considered useful as an adjunctive measure and can also be increasingly supported by digital media in the elderly. Complementary therapy components include confrontational treatment of fear-avoidance beliefs (the German AMIKA scale, Ältere Menschen in körperlicher Aktion, "older people in physical action") and naturopathic applications as an active self-help strategy. Since it is unclear how long the achieved therapeutic effects last, follow-up care is of particular importance in therapy for older patients.

The effects of a culturally informed community-based dance movement therapy programme for persons with Parkinson’s disease in India

Dance and movement therapy (DMT) and Western dance forms have been advocated for the effective management of Parkinson’s Disease (PD). This study focuses on including culturally relevant Indian dance concepts in developing and evaluating a community-based DMT programme for PD. This is the first comparative study on DMT for PD conducted in India, with a control group of a ‘physical exercise programme’. 34 People with Parkinson’s Disease (PwPs) were assigned to a ‘DMT intervention’ or a ‘Physical exercise group’ using convenience sampling and they attended weekly 90-minute sessions over 12 weeks. Mood, physical and cognitive functioning, and quality of life were measured pre-and post-interventions. Results and subjective feedback from PwPs suggest that DMT intervention was more effective in improving positive mood and reducing depression in PD as compared to the control group. This study concludes that culturally informed community-based DMT programmes hold promise as a supportive intervention for PwPs in India.

Pairing taVNS and CIMT is feasible and may improve upper extremity function in infants.

In this study we combined non-invasive transcutaneous auricular vagal nerve stimulation (taVNS) with 40 h of constraint induced movement therapy (CIMT) in infants. All infants completed the full intervention with no adverse events. Therapists were able to maintain high treatment fidelity and reported high ratings for ease of use and child tolerance. Preliminary results show promising gains on motor outcomes: Mean QUEST increase 19.17 (minimal clinically important difference, MCID 4.89); Mean GMFM increase 13.33 (MCID 1%-3%). Infants also exceeded expectations on Goal Attainment Scores (+1). Early data is promising that taVNS paired with intensive motor CIMT is feasible, reliable, and safe in young infants with hemiplegia, and may help harness activity-dependent plasticity to enhance functional movement.

Priming constraint-induced movement therapy with intermittent theta burst stimulation to enhance upper extremity recovery in patients with stroke: protocol for a randomized controlled study.

The treatments based on motor control and motor learning principles have gained popularity in the last 20 years, as well as non-invasive brain stimulations that enhance neuroplastic changes after stroke. However, the effect of intermittent theta burst stimulation (iTBS) in addition to evidence-based, intensive neurorehabilitation approaches such as modified constraint-induced movement therapy (mCIMT) is yet to be investigated. We aim to establish a protocol for a randomized controlled study investigating the efficiency of mCIMT primed with iTBS after stroke. In this randomized controlled, single-blind study, patients with stroke (N = 17) will be divided into 3 groups: (a) mCIMT + real iTBS, (b) mCIMT + sham iTBS, and (c) mCIMT alone. 600-pulse iTBS will be delivered to the primary motor cortex on the ipsilesional hemisphere, and then, patients will receive mCIMT for 1h/session, 3 sessions/week for 5weeks. Upper extremity recovery will be assessed with Fugl-Meyer Test-Upper Extremity and Wolf Motor Function Test. Electrophysiological assessments, such as Motor-Evoked Potentials, Resting Motor Threshold, Short-Intracortical Inhibition, and Intracortical Facilitation, will also be included. In this study, a protocol of an ongoing intervention study investigating the effectiveness of iTBS on ipsilesional M1 prior to the mCIMT in patients with stroke is proposed. This will be the first study to research priming mCIMT with iTBS and it may have the potential to reveal the true effect of the iTBS when it is added to the high-quality neurorehabilitation approaches. Trial registration number: NCT05308667.

Dance as a mental health therapy in the Metaverse: exploring the therapeutic potential of Dance Movement Therapy as a non-pharmacological treatment in the Metaverse

IntroductionThis study conducts a detailed qualitative review of Alternative Therapies for mental health and proposes a novel design for integrating Non-Pharmacological Interventions into the Metaverse Extended Reality environments.Aim/questionThis study investigates the potential of the Extended Reality environments for Non-Pharmacological Interventions in Mental Health, with a specific focus on Dance Movement Therapy as a preventive and therapeutic strategy for anxiety, depression, and other mental health conditions.MethodThis study conducts qualitative evidence syntheses of primary quantitative data and performs meta-analyses of existing studies of participants reporting anxiety, depression, or other mental health conditions.ResultsDance Movement Therapy in the extended reality environments shows promise as a viable alternative therapy, but data privacy and ethical considerations must be addressed.DiscussionThis study raises significant concerns regarding the privacy and security of participants' data, necessitating the storage of only the metadata in electronically compatible files, in cases where users' data is stored for long-term preservation.Implications for practiceThe outcomes of this study could revolutionize mental health practice, providing effective Non-Pharmacological Interventions for anxiety, depression, and other mental health conditions.

To Study the Effect of Jigsaw Puzzle versus Modified Constraint Induced Movement Therapy on Fine Motor Abilities of Upper Extremities in Individuals with Subacute Stroke - An Experimental Study

To Study the Effect of Jigsaw Puzzle versus Modified Constraint Induced Movement Therapy on Fine Motor Abilities of Upper Extremities in Individuals with Subacute Stroke - An Experimental Study

Investigation of the effect of goal-oriented dance movement therapy on depressive symptoms in people with schizophrenia: a rater-blinded randomised controlled study

Background/Aims Depression is a common symptom in schizophrenia and can negatively affect treatment. The aim of this study was to examine the effects of goal‑oriented dance or movement therapy on depressive symptoms in individuals diagnosed with schizophrenia. Methods The study was designed as a randomised controlled rater‑blinded study, in which 32 individuals diagnosed with schizophrenia were randomly assigned to either the intervention (dance movement therapy) group or control group. The intervention consisted of twice‑weekly goal‑oriented dance movement therapy sessions, with each session lasting approximately 40–50 minutes, for a total of 8 weeks. Depressive symptoms were evaluated using the Calgary Depression Scale for Schizophrenia. Results The depressive symptoms before and after the intervention were compared. No significant differences between groups were observed at baseline. There was no change in the control group, whereas a significant improvement on depressive symptoms was observed in the total Calgary Depression Scale for Schizophrenia score in the dance movement therapy group after the intervention. Conclusions Goal‑oriented dance movement therapy is an effective treatment for the depressive symptoms in schizophrenia patients in addition to conventional treatments. Although the results are favourable, further studies are needed to test its effectiveness. Implications for practice In the traditional treatment of schizophrenia, it is important to evaluate depression and support the treatment with approaches such as dance movement therapy.

Constraint-Induced Movement Therapy Promotes Myelin Remodeling and Motor Function by Mediating Sox2/Fyn Signals in Rats With Hemiplegic Cerebral Palsy.

Hypoxic-ischemic brain injury in infants often leads to hemiplegic motor dysfunction. The mechanism of their motor dysfunction has been attributed to deficiencies of the transcription factor sex-determining region (SRY) box 2 (Sox2) or the non-receptor-type tyrosine kinase Fyn (involved in neuronal signal transduction), which causes a defect in myelin formation. Constraint-induced movement therapy (CIMT) following cerebral hypoxia-ischemia may stimulate myelin growth by regulating Sox2/Fyn, Ras homolog protein family A (RhoA), and rho-associated kinase 2 (ROCK2) expression levels. This study investigated how Sox2/Fyn regulates myelin remodeling following CIMT to improve motor function in rats with hemiplegic cerebral palsy (HCP). To investigate the mechanism of Sox2 involvement in myelin growth and neural function in rats with HCP, Lentivirus (Lenti)-Sox2 adeno-associated virus and negative control-Lenti-Sox2 (LS) adeno-associated virus were injected into the lateral ventricle. The rats were divided into a control group and an HCP group with different interventions (CIMT, LS, or negative control-LS [NS] treatment), yielding the HCP, HCP plus CIMT (HCP + CIMT), HCP + LS, HCP + LS + CIMT, HCP + NS, and HCP + NS + CIMT groups. Front-limb suspension and RotaRod tests, Golgi-Cox staining, transmission electron microscopy, immunofluorescence staining, western blotting, and quantitative polymerase chain reaction experiments were used to analyze the motor function, dendrite/axon area, myelin ultrastructure, and levels of expression of oligodendrocytes and Sox2/Fyn/RhoA/ROCK2 in the motor cortex. The rats in the HCP + LS + CIMT group had better values for motor function, dendrite/axon area, myelin ultrastructure, oligodendrocytes, and Sox2/Fyn/RhoA/ROCK2 expression in the motor cortex than rats in the HCP and HCP + NS groups. The improvement of motor function and myelin remodeling, the expression of oligodendrocytes, and the expression of Sox2/Fyn/RhoA/ROCK2 in the HCP + LS group were similar to those in the HCP + CIMT group. CIMT might overcome RhoA/ROCK2 signaling by upregulating the transcription of Sox2 to Fyn in the brain to induce the maturation and differentiation of oligodendrocytes, thereby promoting myelin remodeling and improving motor function in rats with HCP. The pathway mediated by Sox2/Fyn could be a promising therapeutic target for HCP.

Power to move through: A heuristic self-inquiry of dance movement processing within guided imagery and music

This study was a heuristic self-inquiry of the impact of dance movement therapy (DMT) sessions to process somatic and kinesthetic imagery experienced in Guided Imagery and Music (GIM) sessions. Full transcripts were taken for both DMT and GIM sessions to look for themes and intersections of how dance movement processing may have impacted or influenced the therapeutic integration of GIM sessions. There were four primary themes that emerged for how dance movement processing sessions impacted the researcher’s understanding of GIM sessions. These were reimaging with movement, moving for release of emotion, embodying transpersonal experiences, and movement as aesthetic response. Intentional re-imaging with movement allowed for a continuation of the process begun in GIM sessions, which created opportunities for emotional release and integration of self. Movement was a way of generating artistic response that helped further the researcher’s imaginal world of GIM. Personal reflections and implications for practice are given.

A systematic investigation of detectors for low signal-to-noise ratio EMG signals

Background Active participation of stroke survivors during robot-assisted movement therapy is essential for sensorimotor recovery. Robot-assisted therapy contingent on movement intention is an effective way to encourage patients’ active engagement. For severely impaired stroke patients with no residual movements, a surface electromyogram (EMG) has been shown to be a viable option for detecting movement intention. Although numerous algorithms for EMG detection exist, the detector with the highest accuracy and lowest latency for low signal-to-noise ratio (SNR) remains unknown. Methods This study, therefore, investigates the performance of 13 existing EMG detection algorithms on simulated low SNR (0dB and -3dB) EMG signals generated using three different EMG signal models: Gaussian, Laplacian, and biophysical model. The detector performance was quantified using the false positive rate (FPR), false negative rate (FNR), and detection latency. Any detector that consistently showed FPR and FNR of no more than 20%, and latency of no more than 50ms, was considered an appropriate detector for use in robot-assisted therapy. Results The results indicate that the Modified Hodges detector – a simplified version of the threshold-based Hodges detector introduced in the current study – was the most consistent detector across the different signal models and SNRs. It consistently performed for ~90% and ~40% of the tested trials for 0dB and -3dB SNR, respectively. The two statistical detectors (Gaussian and Laplacian Approximate Generalized Likelihood Ratio) and the Fuzzy Entropy detectors have a slightly lower performance than Modified Hodges. Conclusions Overall, the Modified Hodges, Gaussian and Laplacian Approximate Generalized Likelihood Ratio, and the Fuzzy Entropy detectors were identified as the potential candidates that warrant further investigation with real surface EMG data since they had consistent detection performance on low SNR EMG data.

Efficacy of motor relearning programme on rehabilitation of upper extremity function in stroke patients

Background: The most debilitating condition for stroke patients, impacting their quality of life, is motor impairment in the upper extremities. This study aimed to evaluate the impact of the Motor Relearning Programme (MRP) on enhancing stroke patient’s upper limb motor function. Methods: A systematic review using trial studies from an online journal database published from 2013 to 2023. The participants of this study are stroke patients. The utilization of the MRP is compared with an alternative intervention, with the study aiming to assess the motor function of the upper extremities as its primary outcome. The quality of the trial was assessed using the JBI checklist Results: Eight studies, encompassing 279 stroke patients aged 35 to 70, were incorporated. These trials compared the MRP with various interventions, including mirror therapy, Constraint-Induced Movement Therapy (CIMT), bobath, progressive resisted exercise, thermal stimulation, and bilateral task-related training. The interventions spanned an average duration of 3-8 weeks, with sessions occurring 3-6 times per week and lasting between 30 and 120 minutes each. According to the Joanna Briggs Institute (JBI) assessment, all studies achieved a good quality rating, with total points ranging from 9-12. Notably, six studies demonstrated a significant improvement in upper extremity motor function with MRP, while one showed no significant difference. In contrast, one study indicated that CIMT demonstrated more effective results. Conclusion: MRP significantly improves upper extremity function in stroke patients.

Post-stroke rehabilitation in the peri-pandemic COVID-19 era.

The coronavirus disease 2019 (COVID-19), which arosein late 2019, caused extensive destruction, impacting a substantial proportion of the worldwide population and leading to millions of deaths. Although COVID-19 is mainly linked to respiratory and pulmonary complications, it has the potential to affect neurologic structures as well. Neurological involvement may manifest as minimal and reversible; however, a notable proportion of cases have exhibited pronounced neurological consequences, such as strokes. Endothelial inflammation, hypercoagulation, renin-angiotensin-aldosterone system alterations, and cardiogenic embolism are the pathophysiological mechanismsof stroke under COVID-19 circumstances. Physical activity and exercise have improved several aspects of post-stroke recovery, including cardiovascular health, walking capacity, and upper limb strength. They are commonly used to assist stroke survivors in overcomingtheir motor restrictions. Furthermore, stroke rehabilitation can incorporate a range of specific techniques, including body-weight-supported treadmill applications, constraint-induced movement therapy, robotic rehabilitation interventions, transcranial direct current stimulation, transcranial magnetic stimulation, and prism adaptation training. Under pandemic conditions, there were several barriers to neurological rehabilitation. The most significant of these were individual's fear of infection, which caused them to postpone their rehabilitation applicationsand rehabilitation areas being converted into COVID-19 units. The primary emphasis had turned to COVID-19 treatment. Several valuable data and views were gained in reorganizing rehabilitation during the pandemic, contributing to establishing future views in this regard.

Exploring the implications of the metaverse: opportunities and challenges for dance movement therapy

This paper explores the integration of emerging technologies, specifically the metaverse and virtual reality (VR), into the field of dance movement therapy (DMT). The metaverse is conceptualised as a unified, immersive 3D virtual environment that transcends the limitations of the physical world. The author includes vignettes illustrating the practical application of VR in therapy and relaxation as used currently and speculates about the potential future applications of multi-sensory virtual environments. The paper reflects on the concept of embodiment in VR and its potential implications for DMT, discussing the convergence and divergence of principles. The paper concludes with a discussion on the ethical considerations, highlighting privacy, data security, informed consent, accessibility, inclusivity, psychological impact, therapeutic boundaries, cultural sensitivity, efficacy, evidence-based practice, and ethical development and deployment.

Effectiveness of Constraint Induced Movement Therapy and Proprioceptive Neuromuscular Facilitation on Upper Extremity Functions in Stroke

Background: Stroke is the quickly developing clinical indication of a focal disruption of brain function that lastsmore than 24 hours or results in death, with no discernible cause other than vascular origin. Despite the fact thatthe majority of patients are able to walk again, 30% to 60% of survivors are no longer able to use the arm that wasinjured. CIMT aims at improves both the motor and functional capacities of a paretic arm. PNF exercises alter theorder in which muscles are stimulated, increases the efficiency of joint movement.Purpose: To compare the effectiveness of Constraint Induced Movement Therapy and ProprioceptiveNeuromuscular Facilitation for treating upper extremity functions in stroke.Materials and Methods: A total of 30 participants were selected from Sree Annai Physiotherapy Clinic Chennai.According to the inclusion and exclusion criteria. Subjects willing to participate were allocated into two groupsConstraint Induced Movement Therapy group and Proprioceptive Neuromuscular Facilitation group. Theparticipants underwent Pre-test measurement with Fugl-Meyer Assessment Upper Extremity FMA-UE and wererepeated for Post-test measurement. Study period : November 2022 to April 2023.Results: When comparing the mean differences of the two groups, Constraint Induced Movement Therapygroup displays a greater difference than Proprioceptive Neuromuscular Facilitation group. Therefore, it can besaid that Constraint Induced Movement Therapy is more advantageous for the upper extremity functions thanProprioceptive Neuromuscular Facilitation.Conclusion: The study concluded that Constraint Induced Movement Therapy is found to be more effective thanProprioceptive neuromuscular facilitation technique for upper extremity function recovery.

Effects of Kinesio Taping and Modified Constraint-Induced Movement Therapy on Upper Extremity Function, Quality of Life, and Spasticity in Individuals Recovering from Stroke

Background: Cerebral palsy is a neurological condition affecting children and adolescents, often resulting in hemiparesis and impaired upper limb functionality. Constraint-Induced Movement Therapy (CIMT) has shown promise in rehabilitation, and Kinesio Taping (KT) is increasingly considered for its potential benefits. This study explores the synergistic impact of CIMT and KT on upper limb function and muscle tone in this population, filling a critical gap in research. Objective: To investigate the combined effects of CIMT and KT on upper limb functionality and spasticity in children and adolescents with hemiparesis. Methods: A comprehensive randomized clinical trial adhering to CONSORT guidelines was conducted. Forty-six participants aged 6 to 17 years, diagnosed with hemiparesis due to cerebral palsy, were divided into two groups: CIMT-only and CIMT + KT. Baseline assessments included age, gender, stroke type, time since stroke, and initial upper limb function (FMA-UE, BBT, SF-36, MAS). CIMT sessions were conducted intensively over four weeks, with the CIMT + KT group additionally receiving KT application. Post-intervention assessments were conducted using the same measures. Results: Both the CIMT and CIMT + KT groups demonstrated significant improvements in the use of the affected limb for daily tasks, as indicated by the Motor Activity Log (MAL) scores. The CIMT-only Group showed a mean change in MAL score of 15.4 ± 8.1, while the CIMT + KT Group exhibited a mean change of 10.2 ± 6.5. Strong performance in upper limb functionality, assessed through the Wolf Motor Function Test (WMFT) Functional Ability Scale (FAS), was observed in both groups. The CIMT-only Group demonstrated a mean change in WMFT FAS score of 12.3 ± 6.2, and the CIMT + KT Group had a mean change of 8.4 ± 5.1. Additionally, both groups experienced a notable reduction in muscle tone, assessed using the Modified Ashworth Scale (MAS). The CIMT-only Group had a mean change in MAS score of -0.6 ± 0.4, while the CIMT + KT Group had a mean change of -0.4 ± 0.5. No statistically significant differences were observed between the two groups regarding the quality and quantity of movement. Conclusion: Integrating Kinesio Taping with Constraint-Induced Movement Therapy effectively reduces muscular tone in the wrist and fingers, enhancing upper limb functionality in children and adolescents with hemiparesis. While Kinesio Taping alone and in combination with CIMT demonstrates efficacy, further research is warranted to optimize therapeutic applications.

Outcomes of a Parent-Delivered Baby-mCIMT Model for Infants at High Risk of Unilateral Cerebral Palsy Using Remote Coaching in Telerehabilitation.

There is growing evidence of the positive effects of constraint-induced movement therapy (CIMT) for infants at high risk of unilateral cerebral palsy (UCP) when provided by parents with in-person coaching/supervision from occupational therapists during home visits. The aim of this study is to investigate whether Baby-mCIMT (modifiedCIMT) can be as effective if parents are coached/supervised remotely. In this case-control study, we recruited 20 infants and re-used 18 controls, 4-8-month-old infants in both groups at high risk of UCP. The same protocol regarding inclusion criteria, data collection, and training volume was used in both groups. The training was conducted for two 6-week periods, separated by a 6-week break, consisting of daily 30 min sessions conducted by parents, supported by therapist coaching once a week. The primary outcome was measured using the Hand Assessment for Infants (HAI). There was no difference in the change of HAI units (p = 0.803) or that of the affected-hand raw score (p = 0.942) between the two groups. The remote coaching method was well received by parents. In conclusion, this demonstrates that remote coaching/supervision is as effective as the in-person approach, requiring less time and effort for both families and healthcare providers.