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August 26, 2014

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CI Therapy Helps Children With Cerebral Palsy

A new study from the University of Alabama at Birmingham (UAB) reports that children with cerebral palsy saw an increase in grey matter volume in areas of the brain associated with movement when they underwent constraint-induced therapy (CI).

UAB researchers say the findings of their study, which was published online in the journal Pediatrics, show that structural remodeling of the brain occurs during rehabilitation in a pediatric population.

According to the developer of CI therapy Edward Taub, who was also a co-author of the study, the study “reinforces the idea that CI therapy also remodels the brain, producing a real, physical change in the brain.”

The American Heart Association states that CI therapy restrains the unaffected side of a patient, thus forcing the use of the affected side.  For example, in a stroke patient, the therapist would constrain the unaffected arm of the patient in a sling, thus forcing the patient to use his affected arm intensely for given period of time.

In the study, UAB had ten children ages 2 to 7 with cerebral palsy, undergo a three-week course of CI therapy.

Researchers assessed the grey matter of the brain through voxel-based morphometry (VBM), performed on images acquired through MRI before and after the study.

Chelsey Sterling, the first author of the study and a graduate student in medical psychology at UAB said, “We saw increases in grey matter volume in the sensorimotor cortices on both sides of the brain and in the hippocampus.  These increases were accompanied by large improvements in spontaneous arm use in the home environment.  Notably, increases in grey matter correlated with improvement in motor activity.”

The increase in grey matter volume, according to researchers, could be due to several different processes.  These processes include an increase in synaptic density, the creation of new neurons or glial cells, or the establishment of new blood vessels within the brain.

The children in the study received intensive motor training three hours a day for three weeks.  While undergoing the training, the children’s less affected arm was constrained in a cast, and caregivers were given instructions on how to induce the children to use the more-affected arm at home.

This study proves, says Taub, that CI therapy is effective in improving the rehabilitation of movement after stroke and other neurological injuries in both children and adults.  He also stated that the study proves  the “brain has a remarkable capacity to heal itself when presented with an efficacious rehabilitation intervention such as CI therapy.”

The study also indicates, said another co-author of the study Gitendra Uswatte,  that children with cerebral palsy, when provided with the proper stimulation, can make substantial gains in motor function.

Original story found here.

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