AIM To determine if constraint-induced movement therapy (CIMT) is more effective than standard care in improving upper-limb activity outcomes in children with neonatal brachial plexus palsy (NBPP). METHOD Twenty-one children with NBPP (mean age 25mo, SD=10.3, range=17-48mo; 11 males, 10 females) were enrolled in a crossover trial and randomly allocated to first receive CIMT or standard care, each for 8 weeks. The intervention arm consisted of 3 weeks of casting the unaffected limb followed by 5 weeks of transference activities. The Assisting Hand Assessment (AHA) was used to measure bimanual activity performance at baseline, 8 weeks, and 16 weeks, scored by blinded raters. The Pediatric Motor Activity Log-Revised (PMAL-R) was used as a caregiver-reported secondary outcome measure. RESULTS After concealed random allocation (n=21), there were no significant differences on demographics or baseline measures. CIMT was superior compared to control in terms of bimanual activity performance with a mean difference in AHA change score of 4.8 (SD=10.5, p=0.04, Cohen's δ=0.46). There were no significant differences between treatment conditions on the PMAL-R. INTERPRETATION CIMT is favored over standard care for bimanual activity performance. Future research should investigate a longer follow-up period, additional comparator interventions, and analyse differences by participant characteristics.

中文翻译：

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新生儿臂丛神经麻痹儿童的约束诱导运动疗法：一项随机交叉试验

目的 确定约束诱导运动疗法 (CIMT) 在改善新生儿臂丛神经麻痹 (NBPP) 儿童的上肢活动结果方面是否比标准护理更有效。方法 21 名 NBPP 儿童（平均年龄 25 个月，SD = 10.3，范围 = 17-48 个月；11 名男性，10 名女性）被纳入交叉试验，并随机分配到首先接受 CIMT 或标准护理，每人 8 周。干预组包括 3 周铸造未受影响的肢体，然后是 5 周的移情活动。辅助手评估 (AHA) 用于测量在基线、8 周和 16 周时的双手活动表现，由不知情的评分者评分。小儿运动活动日志修订版 (PMAL-R) 被用作护理人员报告的次要结果测量。结果隐藏随机分配后（n=21），在人口统计或基线措施方面没有显着差异。就双手活动表现而言，CIMT 优于对照组，AHA 变化评分的平均差异为 4.8（SD=10.5，p=0.04，Cohen's δ=0.46）。PMAL-R 的治疗条件之间没有显着差异。解释 CIMT 在双手活动表现方面优于标准护理。未来的研究应该调查更长的随访期、额外的比较干预，并分析参与者特征的差异。PMAL-R 的治疗条件之间没有显着差异。解释 CIMT 在双手活动表现方面优于标准护理。未来的研究应该调查更长的随访期、额外的比较干预，并分析参与者特征的差异。PMAL-R 的治疗条件之间没有显着差异。解释 CIMT 在双手活动表现方面优于标准护理。未来的研究应该调查更长的随访期、额外的比较干预，并分析参与者特征的差异。