With the Children with Hemiparesis Arm and Hand Movement Project (CHAMP) multisite factorial randomized controlled trial, we compared 2 doses and 2 constraint types of constraint-induced movement therapy (CIMT) to usual customary treatment (UCT).

CHAMP randomly assigned 118 2- to 8-year-olds with hemiparetic cerebral palsy to one of 5 treatments with assessments at baseline, end of treatment, and 6 months posttreatment. Primary blinded outcomes were the assisting hand assessment; Peabody Motor Development Scales, Second Edition, Visual Motor Integration; and Quality of Upper Extremity Skills Test Dissociated Movement. Parents rated functioning on the Pediatric Evaluation of Disabilities Inventory-Computer Adaptive Test Daily Activities and Child Motor Activity Log How Often scale. Analyses were focused on blinded and parent-report outcomes and rank-order gains across all measures.

Findings varied in statistical significance when analyzing individual blinded outcomes. parent reports, and rank-order gains. Consistently, high-dose CIMT, regardless of constraint type, produced a pattern of greatest short- and long-term gains (1.7% probability of occurring by chance alone) and significant gains on visual motor integration and dissociated movement at 6 months. O’Brien’s rank-order analyses revealed high-dose CIMT produced significantly greater improvement than a moderate dose or UCT. All CIMT groups improved significantly more in parent-reported functioning, compared with that of UCT. Children with UCT also revealed objective gains (eg, 48% exceeded the smallest-detectable assisting hand assessment change, compared with 71% high-dose CIMT at the end of treatment).

CHAMP provides novel albeit complex findings: although most individual blinded outcomes fell below statistical significance for group differences, high-dose CIMT consistently produced the largest improvements at both time points. An unexpected finding concerns shifts in UCT toward higher dosages, with improved outcomes compared with previous reports.

通过儿童偏瘫手臂和手部运动项目 (CHAMP) 多点因子随机对照试验，我们将 2 种剂量和 2 种约束类型的约束诱导运动疗法 (CIMT) 与常规习惯疗法 (UCT) 进行了比较。

CHAMP 将 118 名 2 至 8 岁偏瘫型脑瘫儿童随机分配到 5 种治疗中的一种，并在基线、治疗结束和治疗后 6 个月进行评估。主要的盲法结果是辅助手评估；皮博迪运动发展量表，第二版，视觉运动集成；和上肢技能测试分离运动的质量。家长在儿科残疾评估清单-计算机自适应测试日常活动和儿童运动活动日志中评估功能多久进行一次缩放。分析的重点是盲法和家长报告的结果以及所有测量的排序增益。

在分析个体盲法结果时，发现的统计显着性不同。家长报告和排名增益。始终如一地，无论约束类型如何，高剂量 CIMT 都产生了最大的短期和长期收益模式（仅偶然发生的概率为 1.7%），并且在 6 个月时视觉运动整合和分离运动有显着收益。O'Brien 的排序分析显示，与中等剂量或 UCT 相比，高剂量 CIMT 产生的改善明显更大。与 UCT 相比，所有 CIMT 组在父母报告的功能方面都有显着改善。UCT 儿童也表现出客观的进步（例如，48% 超过了最小可检测到的辅助手评估变化，而治疗结束时的高剂量 CIMT 为 71%）。

CHAMP 提供了新颖但复杂的发现：尽管大多数个体盲法结果低于组差异的统计显着性，但高剂量 CIMT 在两个时间点始终产生最大的改进。一个意外的发现涉及 UCT 向更高剂量的转变，与以前的报告相比，结果有所改善。