Constraint-induced movement therapy (CIMT) has been demonstrated to yield functional improvements for children with spastic hemiplegic cerebral palsy (CP); however, many studies have reported inconsistent findings with regards to the extent of the benefits observed following the intervention. This study sought to examine the effects of CIMT in the context of a day camp in this population; it also examined the child-therapist (C-T) interaction during the assessment sessions as a potential factor influencing the child’s scores on tests of motor performance. This interaction has not yet been formally measured in the literature, and may influence the perceived outcomes of CIMT. Motor Outcomes: Results demonstrated significant improvements in quality of use of the upper extremity following the intervention; the improvements were maintained at the 3-month follow-up. Analysis of each individual participant yielded additional information on clinically significant improvements. C-T Outcomes: Results demonstrated that the strength of the C-T interaction was significantly and positively correlated with the scores obtained by participants on motor assessments. The results of this study indicate that modified CIMT is effective in inducing lasting and meaningful changes in children with spastic hemiplegic CP. They also suggest that the C-T interaction may contribute to a participant’s performance during the assessment session, which may ultimately affect the perceived outcomes of CIMT. / UOIT

The aims of the Lithuanian Health Programme (1998) are to reduce the death rate in patients following stoke, age younger than 65 years old by 15%, and by 10% in patients at age of 65-74 years old, up to year 2010. While trying to enhance the recovery results following the abovementioned disease it is necessary to erect and renew the effective rehabilitation system. The aim is to estimate the effectiveness of The Constrain – Induce Movement Test on arm functions’ recovery of the post - stroke patients. The were two groups of testees, experimental group and control group, each composed of 30 stroke patients. The methods used while writing this study were as follows: the analysis of the used literature sources, and the testing (the evaluation of movements and the Nine Hole Peg Test). The Constrain – Induce Movement Test applied while carrying out this experiment statistically credibly improved the function of the patients’ arms. The average of the evaluation of shoulders arch movements in the control group is 3,13 ± 0,61 points. In the experimental group the average is 4,53 ± 0,97 points. The margin of 1,4 point is statistically reliable (p<0,05). There was also noticed a significant improvement in hand movements in the experimental group. The average of the evaluation of hand movements in the control group is 3,4 ± 0,67 points, while in the experimental group the average is 5,07 ± 0,87 points. The margin is 1,67 points (p<0,05). Analogous results were drawn while estimating... [to full text]

Abstract Background Congenital hemiplegia is the most common form of cerebral palsy accounting for 1 in 1300 live births. Children usually present with greater upper limb than lower limb involvement. Impaired unimanual capacity of the involved upper limb and deficits in bimanual performance contribute to difficulties with day to day activities and participation in home, school and community life. Interventions to address these deficits in upper limb unimanual capacity and bimanual performance have recently shifted focus to address limitations in activity performance rather than underlying impairments. One intensive intervention approach is constraint induced movement therapy, which entails placing a constraint on the unimpaired upper limb to focus intense and repetitive training of the impaired upper limb. To date, it is unclear whether constraint induced movement therapy is superior to a more traditional bimanual therapy to improve activity performance and participation outcomes for children with congenital hemiplegia, as there has been no direct comparison of the two approaches. Aim The primary aim of this research was to determine whether constraint induced movement therapy was more effective than bimanual training to improve activity performance and participation for children with congenital hemiplegia. The specific aims were to: i) determine the efficacy of therapeutic upper limb interventions on activity and participation outcomes for children with congenital hemiplegia, ii) systematically review the clinimetric properties (psychometric properties and clinical utility) of participation assessment tools for children with congenital hemiplegia, iii) examine the relationship between impairments, unimanual capacity and bimanual performance in children with congenital hemiplegia and, iv) determine whether constraint induced movement therapy is more effective than bimanual training to improve activity and participation outcomes for children with congenital hemiplegia. Research Design A matched pairs randomised design was chosen with children matched for age, gender, side of hemiplegia and upper limb function. Children were randomised within pairs to receive either constraint induced movement therapy or bimanual training in equal dosages. Both interventions used a day camp model, with groups receiving the same dosage and content of intervention delivered in the same environment. A novel circus theme was used in the camps to enhance children’s engagement and motivation. Children in the constraint induced movement therapy group wore a tailor made glove on their unimpaired hand during the intervention camp. Outcomes were measured across all domains of the International Classification of Functioning, Disability and Health at baseline, 3 and 26 weeks post intervention. The primary outcome measure for unimanual capacity of the impaired upper limb was the Melbourne Assessment of Unilateral Upper Limb Function, and bimanual performance was the Assisting Hand Assessment. A secondary outcome measure for unimanual capacity was the Jebsen Taylor Test of Hand Function. The Canadian Occupational Performance Measure was used as the primary outcome for participation and three measures, the Assessment of Life Habits, Children’s Assessment of Participation and Enjoyment and the School Function Assessment were included to explore their research utility and responsiveness to change. Results Two systematic reviews were performed prior to the commencement of the randomised trial. The first systematic review and meta-analysis of all upper limb interventions for children with congenital hemiplegia identified four treatment approaches with varying evidence to support their efficacy. Interventions included the use of intramuscular Botulinum toxin A injections to the upper limb augmenting upper limb training, neurodevelopmental treatment, constraint induced movement therapy and hand arm intensive bimanual training. Data were pooled for upper limb, self care and individualised outcomes. Results indicated a small to medium treatment effect favouring all four interventions on upper limb outcomes. Large treatment effects favoured intramuscular Botulinum toxin A injections combined with upper limb training for individualised outcomes. Overall, the systematic review and meta-analysis found no upper limb training approach to be superior although Botulinum toxin A injections appeared to provide a consistent supplementary benefit to a variety of upper limb training approaches. However it was unclear which type of upper limb training was optimal. Findings suggested that the two intensive intervention approaches that are the focus of this randomised controlled trial, constraint induced movement therapy and bimanual intensive training, required further research to support their efficacy. The second systematic review was performed to inform choice of participation measures for the randomised comparison trial. The review identified five specific measures of participation suitable for school aged children with congenital hemiplegia (Assessment of Life Habits, Children’s Assessment of Participation and Enjoyment, School Function Assessment (participation domain), Children Helping Out: Responsibilities and Expectations, School Outcome Measure) and two measures of individualised outcomes that could include specific participation goals (Goal Attainment Scaling and Canadian Occupational Performance Measure). Results suggested that no one measure adequately captured all aspects of participation as outlined in the International Classification of Functioning, Disability and Health, and a combination of assessments would be required to broadly assess children’s participation in home, school and community life. The Canadian Occupational Performance Measure was selected as the primary outcome measure in the randomised trial as it had strong evidence for validity and reliability, had been used in paediatric clinical trials and was responsive to change. Three measures of participation, the Assessment of Life Habits which was completed by the parent/caregiver, the Children’s Assessment of Participation and Enjoyment which was completed by the child, and the School Function Assessment, which was completed by the child’s teacher, were selected to explore the research utility of the measures and their responsiveness to change. Analysis of cross-sectional data collected during screening and baseline assessments for the randomised trial found a strong relationship between bimanual performance and unimanual capacity. Scores on the Melbourne Assessment of Unilateral Upper Limb Function and stereognosis accounted for a significant amount of variance in scores on the Assisting Hand Assessment. There were only moderate associations between impairments (eg. sensory deficits and reduced grip strength) and bimanual performance and unimanual capacity. Age, gender, grip strength and two-point discrimination did not significantly influence bimanual performance. Results of the randomised controlled trial found no differences between groups on any baseline measure. A significant difference between groups favouring the constraint induced movement therapy group was found at 26 weeks on the Melbourne Assessment of Unilateral Upper Limb Function. There were no differences between groups on any other measure at either immediately post intervention at 3 weeks or in the medium term at 26 weeks. The constraint induced movement therapy group made significant gains in unimanual capacity (Melbourne Assessment of Unilateral Upper Limb Function and Jebsen Taylor Test of Hand Function) from baseline to 3 and 26 weeks. The bimanual group demonstrated significant improvement in movement efficiency (Jebsen Taylor Test of Hand Function) by 26 weeks. Significant gains in bimanual performance (Assisting Hand Assessment) were evidenced for both groups from baseline to 3 weeks. These gains were maintained at 26 weeks by the bimanual group only. There were no differences between groups on any participation measures. Both constraint induced movement therapy and bimanual training groups made statistically and clinically significant changes in perceived performance and satisfaction of identified functional goals from baseline to 3 and 26 weeks. Significant gains were made by both groups in personal care on the Assessment of Life Habits from baseline to 26 weeks. There were no changes for either group on the School Function Assessment and Children’s Assessment of Participation and Enjoyment. Conclusions This study found minimal differences between the two training approaches. Outcomes achieved by children reflected the mode of upper limb training, that is, improved and sustained gains in unimanual capacity were achieved with a unimanual approach (constraint induced movement therapy), and significant change in bimanual performance was achieved following bimanual training. The constraint induced movement therapy group made initial improvements in bimanual performance that were not sustained at 26 weeks, suggesting that intensive unimanual training may need to be followed by bimanual training in order to retain effects. Both interventions resulted in significant improvements in the achievement of individualised outcomes. Small gains in participation appeared to correspond with specific goal areas identified by children and their caregivers and highlighted the importance of goal directed training and measuring individualised outcomes. Regardless of the type of approach, intervention needs to be goal-directed, focusing on areas of central importance for children and their families.

Thesis (Ph. D.)--University of Alabama at Birmingham, 2009. / Title from PDF title page (viewed Mar. 31, 2010). Additional advisors: N. Shastry Akella, James E. Cox, Gitendra Uswatte, Victor W. Mark. Includes bibliographical references (p. 50-60).

Thesis (Ph. D.)--University of Massachusetts Amherst, 2010. / Includes bibliographical references (p. 125-136).

Thesis (Ph.D.)--University of Delaware, 2006. / Principal faculty advisor: James (Cole) C. Galloway, Dept. of Physical Therapy. Includes bibliographical references.

Title: The influence of the dance movement therapy on psychomotor symptoms of Parkinson's disease patients Objectives: The aim of this thesis is to evaluate the effects of dance movement therapy on postural instability and other motor and non-motor symptomatology of patients with Parkinson's disease. Changes are evaluated by using MDS-UPDRS and Computerized Dynamic Posturography (NeuroCom Smart EquiTest System). Another goal is to provide comprehensive information about dance movement therapy and other dance therapies promoted abroad and to highlight a possibility of their use as a non-pharmacological treatment of Parkinson's disease symptoms. Methods: This pilot study involved eight late onset Parkinson's disease patients at an average age of 68,87±6,69 years. Changes in their postural stability and motor and non-motor symptoms of Parkinson's disease were evaluated after the completion of two months of intensive dance movement therapy. Observed parameters were evaluated by using MDS- UPDRS and the Computerized Dynamic Posturography Smart EquiTest System created by the NeuroCom company, before and after the therapeutic programme. For effective assessment of the therapy, statistical methods (the Student's paired t-test and the Wilcoxon rank sum test) were used along with the rate of clinical...

A lack of fundamental movement skill (FMS) proficiency in children can contribute to decreased physical activity (PA) levels, increased adiposity and poor acquisition of specialised sport specific movement skills. To prevent the latter, the identification of FMS status in early and middle childhood years is needed for targeted and specific interventions. Against the backdrop of physical education being omitted from the South African school curriculum, the presence of a patriarchal society, gender sporting stereotyping, high levels of unemployment and low education levels; the assessment of FMS status is particularly warranted. Aim of Study: The primary aim of this study was to assess the FMS proficiency of girls aged 9-to-12 years from previously disadvantaged communities within Nelson Mandela Bay. Methodology:A descriptive-exploratory-contextual study design, employing quantitative assessment techniques, was utilized. The sample comprised of 227 girls. Convenience sampling was employed. Testing consisted of FMS proficiency tests in the 20m and 40m sprint, standing long jump, throwing for distance, catching, static balance and throwing for accuracy. FMS process scores were assessed with the body component (BC) and Test of Gross Motor Development II (TGMD II) approaches. Anthropometric measurements of the standing and seated height, mass, arm span and leg length were additionally measured. Microsoft Excel® and Statistica® were used for descriptive and inferential statistical analysis. In the case of significant ANOVA results, the Scheffe post hoc test was used for pairwise comparisons. Statistical significance was set at p<.05 and practical significance (Cohen’s d) was set at d>.2. Pearson Correlation Coefficient identified statistical and practical correlations between two variables and chi square was applied to indicate differences in frequency distribution tables. Cramer’s V values were applied to determine practical significance in the case where statistical significant differences were identified between sets of frequency distributions.

The performer's conceptualisation and perception of herself is projected through the acoustic voice and impacts upon vocal delivery in rehearsal and performance. However, in the context of performer voice training in Western theatre practice the performer's sense of self, or identity, is seldom the focus of development. Vocal development is inherently a transformational process that requires the performer to expand beyond what has become habitual selfexpression. Since vocal expression is embedded in identity, an attempt to change the voice necessitates a deeper understanding, questioning, and challenging of the performer's established sense of self. In this dissertation I posit that acoustic vocal development can be successfully achieved through an embodied and imaginative approach that investigates the performer's metaphorical voice through learning opportunities provided by a process that integrates the practices of Voice Movement Therapy (VMT) and maskwork. This dissertation presents art-based autoethnographic research into the potential value of such an integrated approach to performer vocal development. The VMT maskwork approach is fundamentally an embodied and envoiced process that provides a vastly different and heightened experience of the bodymind and invites the performer to play in the liminal realm of active imagination, which is triggered by the mask-image. The dissertation investigates the vocal development benefits of using self-made masks as a psychophysical training tool to expand the performer's understanding and experience of the bodymind. The area of archetypes and subpersonalities has been identified as a primary intersection between the two modalities and three ways of working are proposed, either taking impulses from the image (mask-image and/or imagination), the body and its movement, or the voice. These three ways of working trigger the bodymind into a process of active imagination that evokes a creative and integrated mask-voice-body exploration of archetypes and/or subpersonalities. The process gives permission to, and provides a safe container for, the amplified expression of the extremes of self and voice. This dissertation offers a tri-phase VMT maskwork process structure, and highlights key steps for the VMT practitioner-led facilitation of such a process. It positions the mask as a useful transitional object which encourages reengagement with imagination, body, voice and emotion, and thus encourages an on-going and multi-layered reflection and investigation of self and voice is possible. The research showed that the integrated approach of VMT maskwork resulted in vocal expansion in all 10 of the VMT 10 vocal components; pitch, pitch fluctuation, loudness, glottal engagement, free air, disruption, violin, register, timbre and articulation. Apart from acoustic vocal expansion, the approach fostered expansion in the performer's metaphorical voice and resulted in improved grounding and confidence in performance. These conclusions support the research statement that VMT maskwork may be a valuable approach to vocal development in the context of theatre performer voice training. As researcher practitioner I hold that the embodied learning process of VMT maskwork exposes the performer to a vastly different experience of self, which fosters a process of self-reflexivity leading to personal meaning making, self-knowledge, the challenging of vocal habits, and ultimately, vocal transformation. / Dissertation (MA)--University of Pretoria, 2016. / Drama / MA / Unrestricted

Bakgrund: Cerebral pares (CP) är den vanligaste fysiska funktionsnedsättningen bland barn. Constraint-induced movement therapy (CIMT) syftar till att öka funktion i den nedsatta handen. Det finns en kunskapslucka kring föräldrars upplevelser av CIMT-träning i barnets vardag. Syfte: Syftet var att undersöka och beskriva upplevelser av CIMT via funktionell terapi bland föräldrar till barn med spastisk hemiplegisk cerebral pares, med fokus på föräldramedverkan, genomförande och följsamhet. Metod: Designen var en kvalitativ intervjustudie med semistrukturerade intervjuer. Metodansatsen var en induktiv kvalitativ innehållsanalys. Resultat: Nio föräldrar från sju familjer deltog i studien. Föräldrarna hade barn i åldrarna fyra till sju år med Gross Motor Function Classification System (GMFCS) 1. Studien resulterade i fyra huvudkategorier; Hinder som måste övervinnas, Draghjälp och stöd, Hantera förväntningar och Lösningar för att få träning att fungera i vardagskontexten, med tillhörande underkategorier. Resultatet visade att tiden är det största hindret och att inblandning av lek är den bästa lösningen att få till träningen i vardagen. Egna förväntningar på sig själv och vikten av yttre stöd beskrevs. Föräldramedverkan visades vara avgörande för genomförande av interventionen. Konklusion: Det är av vikt att ta vara på föräldrarnas upplevelser för bästa genomförande och för att gynna följsamhet vid CIMT. Resultatet kan användas för att utveckla interventionen inom aktuell region.