A Randomised Trial of Constraint Induced Movement Therapy and Botulinum Toxin A in children with Congenital Hemiplegia. [ 2006 - 2008 ]

Research Grant

Researchers: Prof Roslyn Boyd (Principal investigator) ,  A/Pr Ann Christian Eliasson ,  A/Pr David Abbott ,  Prof Meg Morris ,  Prof Steven Wolfe

Brief description Congenital hemiplegia occurs in over 1 million children under 21 years of age in the industrialized world. It is the most common type of cerebral palsy, accounting for 36 percent of children diagnosed with this lifelong condition. We intend to determine if a promising new treatment approach is effective in providing a superior and lasting benefit, compared to conventional techniques. Children with hemiplegia usually have the intellectual capacity to attend normal school; however the impaired arm reduces independence in activities of daily living and can compromise their ability to participate in educational, leisure and vocational roles. Previously we have shown that a program of upper limb rehabilitation in children with spasticity was effective in improving participation and quality of life. We have also shown that rehabilitation combined with Botulinum toxin A (Botox) can further improve functional activity. We believe that a new method of therapy, that has been used effectively in Adults with stroke, called Constraint Induced Movement Therapy (CIMT) may also be beneficial in the treatment of children with congenital hemiplegia. In CIMT, the unimpaired arm is constrained in a glove to promote use of the impaired arm (hemiplegic arm). We predict that, combined with the Botox treatment, CIMT will provide a superior and longer lasting benefit compared to standard rehabilitation combined with Botox. The primary aim of our study is to test this hypothesis in a controlled trial. A secondary aim is to further our understanding of the central neurovascular mechanisms underlying changes in upper limb function. To achieve this, we will use Functional Magnetic Resonance Imaging (fMRI) and Transcranial Magnetic Stimulation (TMS) to measure central activation in the parts of the brain controlling movement. Improving our understanding of the mechanisms involved in this condition is an essential next step towards providing a more effective and long lasting treatment.

Funding Amount $AUD 399,995.69

Funding Scheme NHMRC Project Grants

Notes Standard Project Grant