Ehab Mohamed Abd El-Kafy, Nahla Ahmad Almatrafi, Mohamed Salaheldien Alayat, Nawal Alami Tawhari, Najwa Fawzi Abuallam, Hayam Mahmoud Mahmoud
{"title":"改良约束诱导运动疗法对偏瘫性脑瘫患儿上肢功能的影响。系统回顾和荟萃分析。","authors":"Ehab Mohamed Abd El-Kafy, Nahla Ahmad Almatrafi, Mohamed Salaheldien Alayat, Nawal Alami Tawhari, Najwa Fawzi Abuallam, Hayam Mahmoud Mahmoud","doi":"10.1055/a-2616-4893","DOIUrl":null,"url":null,"abstract":"<p><p>To assess the effectiveness of modified constraint-induced movement therapy (mCIMT) in improving upper limb function and grip strength in children with hemiplegic cerebral palsy (CP).A comprehensive search was conducted from inception to August 2024. Eligibility criteria were studies evaluating the effectiveness of mCIMT on upper limb function in children with hemiplegic CP aged over 2 years. The following data was extracted from each study: participant characteristics, intervention, outcome measures, follow-up, and key findings. The risk of bias and the quality of the evidence were evaluated using the PEDro scale and the grading of recommendations assessment development and evaluation (GRADE), respectively. A meta-analysis using a random-effect model was performed, and standardized mean difference (SMD) with a 95% confidence interval (CI) was estimated for upper limb function and grip strength.A total of 25 studies (1,115 children) were included. PEDro scale revealed 12 good-quality studies, 8 fair-quality studies, and 5 poor-quality studies. The currently available evidence showed a significant large effect of mCIMT in improving upper limb function (SMD: 1.14 [95% CI: 0.46-1.83]; <i>p</i> = 0.001; 12 studies; 454 children; very-low-quality evidence) and significant medium effect in improving grip strength (SMD: 0.63 [95% CI: 0.12-1.14]; <i>p</i> = 0.02; 3 studies; 92 children; low-quality evidence).mCIMT could improve upper limb function and grip strength in children with hemiplegic CP. However, due to the low and very low quality of evidence, further high-quality trials are needed to confirm these effects.PROSPERO registration number (CRD42023413525).</p>","PeriodicalId":19421,"journal":{"name":"Neuropediatrics","volume":" ","pages":""},"PeriodicalIF":1.1000,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effect of Modified Constraint-Induced Movement Therapy on Upper Limb Function in Children with Hemiplegic Cerebral Palsy.\",\"authors\":\"Ehab Mohamed Abd El-Kafy, Nahla Ahmad Almatrafi, Mohamed Salaheldien Alayat, Nawal Alami Tawhari, Najwa Fawzi Abuallam, Hayam Mahmoud Mahmoud\",\"doi\":\"10.1055/a-2616-4893\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>To assess the effectiveness of modified constraint-induced movement therapy (mCIMT) in improving upper limb function and grip strength in children with hemiplegic cerebral palsy (CP).A comprehensive search was conducted from inception to August 2024. Eligibility criteria were studies evaluating the effectiveness of mCIMT on upper limb function in children with hemiplegic CP aged over 2 years. The following data was extracted from each study: participant characteristics, intervention, outcome measures, follow-up, and key findings. The risk of bias and the quality of the evidence were evaluated using the PEDro scale and the grading of recommendations assessment development and evaluation (GRADE), respectively. A meta-analysis using a random-effect model was performed, and standardized mean difference (SMD) with a 95% confidence interval (CI) was estimated for upper limb function and grip strength.A total of 25 studies (1,115 children) were included. PEDro scale revealed 12 good-quality studies, 8 fair-quality studies, and 5 poor-quality studies. The currently available evidence showed a significant large effect of mCIMT in improving upper limb function (SMD: 1.14 [95% CI: 0.46-1.83]; <i>p</i> = 0.001; 12 studies; 454 children; very-low-quality evidence) and significant medium effect in improving grip strength (SMD: 0.63 [95% CI: 0.12-1.14]; <i>p</i> = 0.02; 3 studies; 92 children; low-quality evidence).mCIMT could improve upper limb function and grip strength in children with hemiplegic CP. However, due to the low and very low quality of evidence, further high-quality trials are needed to confirm these effects.PROSPERO registration number (CRD42023413525).</p>\",\"PeriodicalId\":19421,\"journal\":{\"name\":\"Neuropediatrics\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2025-06-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neuropediatrics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1055/a-2616-4893\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neuropediatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/a-2616-4893","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:评价改良约束诱导运动疗法(mCIMT)改善偏瘫性脑瘫(CP)患儿上肢功能和握力的效果。方法:从成立到2024年8月进行全面检索。入选标准是评估mCIMT对2岁以上偏瘫CP患儿上肢功能的有效性的研究。从每项研究中提取以下数据:参与者特征、干预措施、结果测量、随访和主要发现。偏倚风险和证据质量分别采用PEDro量表和建议评估发展与评价分级(GRADE)进行评估。采用随机效应模型进行meta分析,估计上肢功能和握力的标准化平均差(SMD)为95%置信区间(CI)。结果:共纳入25项研究(1115名儿童)。PEDro量表显示12项高质量研究,8项中等质量研究,5项低质量研究。目前可获得的证据表明,mCIMT在改善上肢功能方面有显著的大效果(SMD 1.14 [95% CI 0.46 ~ 1.83];P = 0.001;12的研究;454名儿童;极低质量证据)和显著的中等效果改善握力(SMD 0.63 [95% CI 0.12至1.14];P = 0.02;3研究;92名儿童;低质量证据)。结论:mCIMT可以改善偏瘫CP患儿的上肢功能和握力,但由于证据质量较低和极低,需要进一步的高质量试验来证实这些效果。
Effect of Modified Constraint-Induced Movement Therapy on Upper Limb Function in Children with Hemiplegic Cerebral Palsy.
To assess the effectiveness of modified constraint-induced movement therapy (mCIMT) in improving upper limb function and grip strength in children with hemiplegic cerebral palsy (CP).A comprehensive search was conducted from inception to August 2024. Eligibility criteria were studies evaluating the effectiveness of mCIMT on upper limb function in children with hemiplegic CP aged over 2 years. The following data was extracted from each study: participant characteristics, intervention, outcome measures, follow-up, and key findings. The risk of bias and the quality of the evidence were evaluated using the PEDro scale and the grading of recommendations assessment development and evaluation (GRADE), respectively. A meta-analysis using a random-effect model was performed, and standardized mean difference (SMD) with a 95% confidence interval (CI) was estimated for upper limb function and grip strength.A total of 25 studies (1,115 children) were included. PEDro scale revealed 12 good-quality studies, 8 fair-quality studies, and 5 poor-quality studies. The currently available evidence showed a significant large effect of mCIMT in improving upper limb function (SMD: 1.14 [95% CI: 0.46-1.83]; p = 0.001; 12 studies; 454 children; very-low-quality evidence) and significant medium effect in improving grip strength (SMD: 0.63 [95% CI: 0.12-1.14]; p = 0.02; 3 studies; 92 children; low-quality evidence).mCIMT could improve upper limb function and grip strength in children with hemiplegic CP. However, due to the low and very low quality of evidence, further high-quality trials are needed to confirm these effects.PROSPERO registration number (CRD42023413525).
期刊介绍:
For key insights into today''s practice of pediatric neurology, Neuropediatrics is the worldwide journal of choice. Original articles, case reports and panel discussions are the distinctive features of a journal that always keeps abreast of current developments and trends - the reason it has developed into an internationally recognized forum for specialists throughout the world.
Pediatricians, neurologists, neurosurgeons, and neurobiologists will find it essential reading.