• Therapeutic Science for Rehabilitation
• /
• v.4 no.1
• /
• pp.7-17
• /
• 2015

Objective : To investigate the current researches which identify the improvement of bilateral coordination skill of children with hemiplegic cerebral palsy after bimanual intensive training. Methods : We systematically examined papers published in journals from 2004 to 2014, using RISS, Pubmed. Total 6 studies were included in the analyses. Result : All of the selected 6 studies were foreign papers, and the Pedro score was 5 or more. Among various interventions, modified CIMT designs were the most. The primary outcome measure tools are AHA and JTTHF for evaluating bilateral coordination and hand functions, and QUEST, ABILHAND-Kids, COPM, GAS, PEDI, 3-D movement kinematics were used for evaluating various aspects of effectiveness of interventions. Conclusion : Through this systematic review, it is identified that bilateral intensive training provides positive effects to not only hand functions but also bilateral coordination. Furthermore, it also provided supports to participate in ADL requiring bilateral coordination. These results will provides evidence concerning the effectiveness of BIT for children with hemiplegic cerebral palsy.

• Physical Therapy Korea
• /
• v.9 no.3
• /
• pp.67-76
• /
• 2002

We report the reorganization of motor network resulted from intensive unilateral coordination training and the effect of cross education on the untrained side in patient with traumatic brain injury using functional magnetic resonance imaging (fMRI). A 22 year-old male patient who had suffered from diffuse axonal injury for 58 months showed coordination deficit in the left hand at initial examination. Intensive motor training including complex finger movements and coordination activities using a metronome was introduced to the patient 4 hours per day for a week. FMRI was performed on a 3T ISOL Forte scanner. All functional images were analyzed using SPM-99 software. Hand function was improved after training not only in the trained left hand, but also in the untrained right hand. There was no activation in the right primary motor area (M1) during left hand movement before training whereas robust activation of left M1 was demonstrated by the right hand movement. Profuse activation of bilateral prefrontal lobes was seen during both hand movements before training. After training of left hand, right M1 became prominently activated during the left hand motion. The activation of bilateral prefrontal lobes disappeared after training not only for the left hand movement but also for the right, which clearly demonstrated the effect of cross education. This case report demonstrated the learning-dependent reorganization of the M1 and the effect of cross education.

• Physical Therapy Korea
• /
• v.17 no.4
• /
• pp.77-87
• /
• 2010

The present case study highlights the effects of a novel Comprehensive Hand Repetitive Intensive Strengthening Training (CHRIST) on morphological changes and associated upper extremity (UE) muscle strength and motor performance in a child with spastic quadriplegic cerebral palsy (CP). The Child, a 10-year-old girl with spastic quadriplegic CP, was treated with CHRIST for 60 minutes a day, five times a week, for 5 weeks. The CHRIST was designed to improve motor function and strength. Clinical tests including the modified Wolf Test, Jebsen-Taylor Hand Function Test, and Pediatric Motor Activity Log questionnaire were used to determine motor function. Ultrasound imaging was performed to determine the changes in the cross-section area (CSA) of the extensor carpi radialis (ECR) and triceps brachii (TRI). Muscle strength was measured with a dynamometer at pretest, and post-test, and 3-month follow-up. Ultrasound imaging data showed that the CSAs of both ECR and TRI muscles were enhanced as a function of the intervention. These changes were associated with muscle strength and motor performance and their effects remained even at a 3-month follow-up test. Our results suggest that the CHRIST was effective at treating muscle atrophy, weakness and motor dysfunction in a child with spastic quadriplegic CP.