human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The goal of this study was to determine the progression of manual dexterity during 6 weeks ( 54h ) ( modified ) constraint-induced movement therapy ( (m)CIMT ) followed by 2 weeks ( 18h ) bimanual training ( BiT ) in children with unilateral spastic cerebral palsy ( CP ) , to establish whether and when a maximal training effect was reached and which factors might influence the motor learning curve . In addition , long-term retention of effects was determined . In a r and omized controlled trial of 52 children with CP , aged 2.5 - 8 years , comparing mCIMT-BiT to conventional therapy  , 28 children were allocated to the mCIMT-BiT group . This group was assessed weekly with the Box and Block test . Long-term effectiveness was determined by collecting follow-up data of the primary ( Assisting H and Assessment , ABILH AND -Kids ) and secondary ( Melbourne , COPM ) outcomes at six months and one year after intervention . Fifteen children ( 53.6 % ) reached a maximum training effect within the mCIMT period . This group differed from others with respect to age , but not gender , affected side or manual ability . Children younger than five years had a greater chance to reach a maximum score within 6 weeks mCIMT ( OR=6.67 , 95%CI=1.24 - 35.71 ) that stabilized already after four weeks ; older children showed a longer progression and tended to decline afterwards . In both age groups , beneficial effects were retained in the long term . The findings suggest that children of 5 years and older might profit from a longer period of mCIMT than 54h to reach their maximum unimanual capacity and to retain this capacity during subsequent bimanual training OBJECTIVE Pediatric constraint-induced movement therapy ( CIMT ) is a promising intervention for children with unilateral cerebral palsy ( CP ) . This multisite r and omized controlled trial ( RCT ) tested the hypothesis that 6 hr versus 3 hr per day for 21 days would produce larger maintenance of gains 6 mo posttreatment . METHOD Three sites recruited 18 children ( 6 per site ) ages 3 - 6 yr with unilateral CP . Children were r and omly assigned 3 to 6 hr/day of CIMT for 21 days and wore a cast on the unaffected extremity the first 18 days . Occupational therapists applied a st and ardized pediatric CIMT protocol . Evaluators blinded to condition administered the ASsisted H and Assessment and the Quality of Upper Extremity Skills Test , and parents completed the  Pediatric Motor Activity Log  pre- and posttreatment ( 1 wk , 1 mo , and 6 mo ) . RESULTS Both CIMT dosage groups showed significant gains on all five assessment s with no significant group differences at 6 mo follow-up . Effect sizes ( n = 15 ) comparing preintervention to postintervention measures ( partial η2 ) ranged from .33 to .80 . CONCLUSION The first multisite RCT of pediatric CIMT confirmed the maintenance of positive effects at 6 mo follow-up across multiple functional performance measures . The hypothesis that maintenance of effects would differ for children who received 6 versus 3 hr/day of CIMT ( 126 vs. 63 total hr ) was not supported A recent r and omized controlled trial indicated that modified Constraint-Induced Movement Therapy followed by Bimanual Training ( mCIMT-BiT ) is an effective intervention to improve spontaneous use of the affected upper limb in children with unilateral spastic cerebral palsy ( CP ) . The present study aim ed to investigate how the above-mentioned improvements as a result of 8 weeks mCIMT-BiT were established . 52 children with unilateral spastic CP with Manual Ability Classification System ( MACS ) scores I , II or III and aged 2.5 - 8 years were r and omly allocated to either mCIMT-BiT ( n = 28 ) or Usual Care ( UC ) ( n = 24 ) . Developmental disregard ( ' learned non-use ' ) and upper limb capacity and performance scores were derived from the Video Observations Aarts and Aarts , module Determine Developmental Disregard . Active and passive range of motion at the affected wrist and elbow were assessed using goniometry during isolated movements . Upper limb capacity and performance demonstrated significantly greater improvements after mCIMT-BiT compared to UC , which lasted up to 8 weeks follow-up , whereas developmental disregard and passive and active range of motion did not show differential effects . The results support the notion that improvement of capacity and performance of the upper limb through mCIMT-BiT in children with unilateral spastic CP is based on a better utilization of existing motor functions of the affected arm and h and . However , enhancement of the overall amount of use ( or the reduction of learned non-use ) may still be suboptimal leaving room for improvement of this treatment Objective : To investigate the long-term effects of the ‘ transfer package ’ in constraint-induced movement therapy , which is an optional protocol to facilitate actual use of the trained affected arm in activities of daily living . Design : A pilot quasi-r and omized controlled trial with a blinded single assessor with six-month follow-up . Setting : Hospitalized care at university hospital . Subjects : Twenty-one post-stroke patients were quasi-r and omized to either a group with transfer package during constraint-induced movement therapy or a control group ( without transfer package ) . Interventions : The transfer package group received 4.5 hours of intensive task training and 0.5 hours of transfer package whereas the control group received 5.0 hours of intensive task training per day during 10 consecutive weekdays . Main measures : Arm function was measured with Fugl-Meyer Assessment and Amount of Use score of Motor Activity Log . Results : Twenty-three patients were quasi-r and omized , but data from two patients were missing from the long-term follow-up . Both groups showed increase in arm function postintervention . However , at six months ’ follow-up only the transfer package group showed consistent increase in arm function ( with transfer package group versus control group ; Fugl-Meyer Assessment , mean ( ± SD ) from 48.6 ± 7.8 ( preintervention ) to 55.7 ± 4.5 ( postintervention ) and 59.0 ± 3.6 ( six months postintervention ) versus from 49.1 ± 5.5 to 52.8 ± 6.0 and 53.3 ± 4.9 , P= 0.003 ; Amount of Use scale of Motor Activity Log , mean from 1.3 ± 0.55 ( preintervention ) to 2.12 ± 0.55 ( postintervention ) and 2.79 ± 0.98 ( six months postintervention ) versus from 1.18 ± 0.70 to 1.61 ± 0.54 and 1.65 ± 0.68 , P= 0.002 ) . Conclusions : Our results confirmed the long-term effects of the transfer package in constraint-induced movement therapy OBJECTIVE The aim of this study was to eluci date the feasibility , efficacy , and sustainability of a home-based , two-week , forced-use therapy ( FUT ) program for children with hemiplegic cerebral palsy ( CP ) . METHODS A single-blinded , r and omized controlled design was chosen . The Melbourne Assessment of Unilateral Upper Limb Function ( MA ) was carried out at baseline , pretest , post-test , and follow-up at two weeks , three months , and 12 months . Additionally , a question naire was used to evaluate the clinical relevance and integration of FUT in the home setting . 23 children , ages six to 16 years , took part in the study and were r and omized into either an intervention group ( n=12 , mean age 9.8 ± 3.5 years ) or a control group ( $ n=$ 11 , mean age 11.7 ± 3.7 years ) . The intervention consisted of constraint of the unaffected h and for six hours per day and promotion of different activities of daily living according to an age-related manual for the use of the non-constraint h and . RESULTS Unpaired t-tests for the change in MA scores relative to the pre-test values showed no difference between the groups at any time point : post-test ( p=0.304 ) , two weeks ( p=0.193 ) , or three months ( p=0.957 ) . Improvements in Activities of Daily Living ( ADLs ) assessed by question naires were observed by 64 % of parents of the intervention group . Fifty-five percent of parents stated that the FUT program was exhausting and only 45 % indicated that they achieved constraint for 6 hours per day . CONCLUSION Our results evaluating a home-based FUT program of 14 days show no statistically significant improvement of upper extremity function in children with CP . The lack of compliance and absence of structured exercises proved to be considerable pitfalls of the home-based FUT program . Therefore , future home based FUT concepts should put special emphasis on the close monitoring and support of children and their families , as well as the integration of structured exercise sessions Objective : The aim of this study was to compare the effects of modified constraint-induced movement therapy ( mCIMT ; restraint of unaffected limb combined with unimanual intensive rehabilitation ) with those of a bimanual intensive rehabilitation treatment ( IRP ) in children with hemiplegic cerebral palsy after a 10-wk practice vs.  st and ard treatment ( ST ) . Design : This study is a multicenter , cluster-r and omized controlled clinical trial of tested groups of children with hemiplegic cerebral palsy treated using mCIMT , IRP , or ST . For 10 wks , in mCIMT and IRP , the intensive practice lasted 3 hrs/day , 7 days/wk ; in ST , 1-hr sessions twice a week were provided . The primary outcomes are upper limb/h and function ( Quality of Upper Extremity Skills Test ) and activities of daily living ( Besta Scale ) , which are assessed before and after treatment . One hundred five patients were recruited , 39 to the mCIMT group , 33 to the IRP group , and 33 to the ST group . Results : IRP and mCIMT significantly improved paretic h and function both in the Quality of Upper Extremity Skills Test and in the Besta Scale , whereas ST did not . mCIMT improved grasp more than IRP did ( P < 0.01 ) , whereas bimanual spontaneous use in play increased more with IRP ( P = 0.0005 ) . Activities of daily living in 2- to 6-yr-olds improved more with IRP ( P < 0.0001 ) than with mCIMT ( P = 0.011 ) . Unaffected limb improved more from bimanual practice ( IRP ; P = 0.02 ) . Conclusions : More advantages result ed from intensive practice than in the st and ard one , in mCIMT for grasp and in IRP for bimanual spontaneous use and activities of daily living in younger children Purpose : To determine the effects of treatment environment ( home and clinic ) on results of modified constraint-induced movement therapy ( modified CIMT ) in children with spastic hemiplegic cerebral palsy . Method : In a single-blinded , r and omized , controlled trial , 14 children with spastic hemiplegic cerebral palsy ( 5 females , 9 males ; mean age : 74 months ) received 15 hours of modified CIMT , occurring three times/week for 10 sessions every other day in two r and omly assigned groups . Each session lasts one and half hours . Treatment environment for intervention group ( n = 7 ) was home and for control group ( n = 7 ) was clinic . Measures were conducted pre , post and 3 months after treatment period by pediatrics motor activity log and subtests 5 ( upper limb coordination ) and 8 ( upper limb speed and dexterity ) of Bruininks – Oseretsky test of motor proficiency . Sample r and omization and data analysis by analysis of variance with repeated measures were conducted by SPSS-16 software in α level set at p < 0.05 . Results : All subjects showed significant improvement ( p < 0.01 ) in post-test measures except subtest 5 of Bruininks – Oseretsky test of motor proficiency . In contrast to clinic group , subjects in home showed significantly continued improvement at follow-up session in all measures . Conclusions : Modified CIMT is effective in improving upper limb function in children with spastic hemiplegic cerebral palsy . In addition , more improved performance in home group places the practice in natural context as the preferred method for treatment of these children . Implication s for Rehabilitation In hemiplegic cerebral palsy , one side of the body is more affected , which is a consequence of non-progressive impairments in the brain . Constraint-induced movement therapy tries to improve upper limb function of hemiparetic children by restraint of the less-affected h and and intensive training of the more-affected h and . This study shows more improvement of h and function through implementing constraint-induced movement therapy in home than clinic . In a r and omized , controlled trial , our study shows the positive effects of practice in natural environments compared to simulated environments such as clinic OBJECTIVE To delineate characteristics of best responders in a r and omized trial comparing constraint-induced movement therapy ( CIMT ) to bimanual training for children with unilateral cerebral palsy . DESIGN Secondary analysis of a single-blind matched-pairs r and omized comparison trial . SETTING Community sporting facilities in 2 Australian capital cities . PARTICIPANTS Children ( n=64 ; mean age , 10.2±2.7y ; 52 % boys ) , matched for age , sex , side of hemiplegia , and upper-limb function , were r and omized within pairs to CIMT or bimanual training .  Sixty-one children who completed CIMT ( n=31 ) or b 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The goal of this study was to determine the progression of manual dexterity during 6 weeks ( 54h ) ( modified ) constraint-induced movement therapy ( (m)CIMT ) followed by 2 weeks ( 18h ) bimanual training ( BiT ) in children with unilateral spastic cerebral palsy ( CP ) , to establish whether and when a maximal training effect was reached and which factors might influence the motor learning curve . In addition , long-term retention of effects was determined . In a r and omized controlled trial of 52 children with CP , aged 2.5 - 8 years , comparing mCIMT-BiT to conventional therapy  , 28 children were allocated to the mCIMT-BiT group . This group was assessed weekly with the Box and Block test . Long-term effectiveness was determined by collecting follow-up data of the primary ( Assisting H and Assessment , ABILH AND -Kids ) and secondary ( Melbourne , COPM ) outcomes at six months and one year after intervention . Fifteen children ( 53.6 % ) reached a maximum training effect within the mCIMT period . This group differed from others with respect to age , but not gender , affected side or manual ability . Children younger than five years had a greater chance to reach a maximum score within 6 weeks mCIMT ( OR=6.67 , 95%CI=1.24 - 35.71 ) that stabilized already after four weeks ; older children showed a longer progression and tended to decline afterwards . In both age groups , beneficial effects were retained in the long term . The findings suggest that children of 5 years and older might profit from a longer period of mCIMT than 54h to reach their maximum unimanual capacity and to retain this capacity during subsequent bimanual training OBJECTIVE Pediatric constraint-induced movement therapy ( CIMT ) is a promising intervention for children with unilateral cerebral palsy ( CP ) . This multisite r and omized controlled trial ( RCT ) tested the hypothesis that 6 hr versus 3 hr per day for 21 days would produce larger maintenance of gains 6 mo posttreatment . METHOD Three sites recruited 18 children ( 6 per site ) ages 3 - 6 yr with unilateral CP . Children were r and omly assigned 3 to 6 hr/day of CIMT for 21 days and wore a cast on the unaffected extremity the first 18 days . Occupational therapists applied a st and ardized pediatric CIMT protocol . Evaluators blinded to condition administered the ASsisted H and Assessment and the Quality of Upper Extremity Skills Test , and parents completed the  Pediatric Motor Activity Log  pre- and posttreatment ( 1 wk , 1 mo , and 6 mo ) . RESULTS Both CIMT dosage groups showed significant gains on all five assessment s with no significant group differences at 6 mo follow-up . Effect sizes ( n = 15 ) comparing preintervention to postintervention measures ( partial η2 ) ranged from .33 to .80 . CONCLUSION The first multisite RCT of pediatric CIMT confirmed the maintenance of positive effects at 6 mo follow-up across multiple functional performance measures . The hypothesis that maintenance of effects would differ for children who received 6 versus 3 hr/day of CIMT ( 126 vs. 63 total hr ) was not supported A recent r and omized controlled trial indicated that modified Constraint-Induced Movement Therapy followed by Bimanual Training ( mCIMT-BiT ) is an effective intervention to improve spontaneous use of the affected upper limb in children with unilateral spastic cerebral palsy ( CP ) . The present study aim ed to investigate how the above-mentioned improvements as a result of 8 weeks mCIMT-BiT were established . 52 children with unilateral spastic CP with Manual Ability Classification System ( MACS ) scores I , II or III and aged 2.5 - 8 years were r and omly allocated to either mCIMT-BiT ( n = 28 ) or Usual Care ( UC ) ( n = 24 ) . Developmental disregard ( ' learned non-use ' ) and upper limb capacity and performance scores were derived from the Video Observations Aarts and Aarts , module Determine Developmental Disregard . Active and passive range of motion at the affected wrist and elbow were assessed using goniometry during isolated movements . Upper limb capacity and performance demonstrated significantly greater improvements after mCIMT-BiT compared to UC , which lasted up to 8 weeks follow-up , whereas developmental disregard and passive and active range of motion did not show differential effects . The results support the notion that improvement of capacity and performance of the upper limb through mCIMT-BiT in children with unilateral spastic CP is based on a better utilization of existing motor functions of the affected arm and h and . However , enhancement of the overall amount of use ( or the reduction of learned non-use ) may still be suboptimal leaving room for improvement of this treatment Objective : To investigate the long-term effects of the ‘ transfer package ’ in constraint-induced movement therapy , which is an optional protocol to facilitate actual use of the trained affected arm in activities of daily living . Design : A pilot quasi-r and omized controlled trial with a blinded single assessor with six-month follow-up . Setting : Hospitalized care at university hospital . Subjects : Twenty-one post-stroke patients were quasi-r and omized to either a group with transfer package during constraint-induced movement therapy or a control group ( without transfer package ) . Interventions : The transfer package group received 4.5 hours of intensive task training and 0.5 hours of transfer package whereas the control group received 5.0 hours of intensive task training per day during 10 consecutive weekdays . Main measures : Arm function was measured with Fugl-Meyer Assessment and Amount of Use score of Motor Activity Log . Results : Twenty-three patients were quasi-r and omized , but data from two patients were missing from the long-term follow-up . Both groups showed increase in arm function postintervention . However , at six months ’ follow-up only the transfer package group showed consistent increase in arm function ( with transfer package group versus control group ; Fugl-Meyer Assessment , mean ( ± SD ) from 48.6 ± 7.8 ( preintervention ) to 55.7 ± 4.5 ( postintervention ) and 59.0 ± 3.6 ( six months postintervention ) versus from 49.1 ± 5.5 to 52.8 ± 6.0 and 53.3 ± 4.9 , P= 0.003 ; Amount of Use scale of Motor Activity Log , mean from 1.3 ± 0.55 ( preintervention ) to 2.12 ± 0.55 ( postintervention ) and 2.79 ± 0.98 ( six months postintervention ) versus from 1.18 ± 0.70 to 1.61 ± 0.54 and 1.65 ± 0.68 , P= 0.002 ) . Conclusions : Our results confirmed the long-term effects of the transfer package in constraint-induced movement therapy OBJECTIVE The aim of this study was to eluci date the feasibility , efficacy , and sustainability of a home-based , two-week , forced-use therapy ( FUT ) program for children with hemiplegic cerebral palsy ( CP ) . METHODS A single-blinded , r and omized controlled design was chosen . The Melbourne Assessment of Unilateral Upper Limb Function ( MA ) was carried out at baseline , pretest , post-test , and follow-up at two weeks , three months , and 12 months . Additionally , a question naire was used to evaluate the clinical relevance and integration of FUT in the home setting . 23 children , ages six to 16 years , took part in the study and were r and omized into either an intervention group ( n=12 , mean age 9.8 ± 3.5 years ) or a control group ( $ n=$ 11 , mean age 11.7 ± 3.7 years ) . The intervention consisted of constraint of the unaffected h and for six hours per day and promotion of different activities of daily living according to an age-related manual for the use of the non-constraint h and . RESULTS Unpaired t-tests for the change in MA scores relative to the pre-test values showed no difference between the groups at any time point : post-test ( p=0.304 ) , two weeks ( p=0.193 ) , or three months ( p=0.957 ) . Improvements in Activities of Daily Living ( ADLs ) assessed by question naires were observed by 64 % of parents of the intervention group . Fifty-five percent of parents stated that the FUT program was exhausting and only 45 % indicated that they achieved constraint for 6 hours per day . CONCLUSION Our results evaluating a home-based FUT program of 14 days show no statistically significant improvement of upper extremity function in children with CP . The lack of compliance and absence of structured exercises proved to be considerable pitfalls of the home-based FUT program . Therefore , future home based FUT concepts should put special emphasis on the close monitoring and support of children and their families , as well as the integration of structured exercise sessions Objective : The aim of this study was to compare the effects of modified constraint-induced movement therapy ( mCIMT ; restraint of unaffected limb combined with unimanual intensive rehabilitation ) with those of a bimanual intensive rehabilitation treatment ( IRP ) in children with hemiplegic cerebral palsy after a 10-wk practice vs.  st and ard treatment ( ST ) . Design : This study is a multicenter , cluster-r and omized controlled clinical trial of tested groups of children with hemiplegic cerebral palsy treated using mCIMT , IRP , or ST . For 10 wks , in mCIMT and IRP , the intensive practice lasted 3 hrs/day , 7 days/wk ; in ST , 1-hr sessions twice a week were provided . The primary outcomes are upper limb/h and function ( Quality of Upper Extremity Skills Test ) and activities of daily living ( Besta Scale ) , which are assessed before and after treatment . One hundred five patients were recruited , 39 to the mCIMT group , 33 to the IRP group , and 33 to the ST group . Results : IRP and mCIMT significantly improved paretic h and function both in the Quality of Upper Extremity Skills Test and in the Besta Scale , whereas ST did not . mCIMT improved grasp more than IRP did ( P < 0.01 ) , whereas bimanual spontaneous use in play increased more with IRP ( P = 0.0005 ) . Activities of daily living in 2- to 6-yr-olds improved more with IRP ( P < 0.0001 ) than with mCIMT ( P = 0.011 ) . Unaffected limb improved more from bimanual practice ( IRP ; P = 0.02 ) . Conclusions : More advantages result ed from intensive practice than in the st and ard one , in mCIMT for grasp and in IRP for bimanual spontaneous use and activities of daily living in younger children Purpose : To determine the effects of treatment environment ( home and clinic ) on results of modified constraint-induced movement therapy ( modified CIMT ) in children with spastic hemiplegic cerebral palsy . Method : In a single-blinded , r and omized , controlled trial , 14 children with spastic hemiplegic cerebral palsy ( 5 females , 9 males ; mean age : 74 months ) received 15 hours of modified CIMT , occurring three times/week for 10 sessions every other day in two r and omly assigned groups . Each session lasts one and half hours . Treatment environment for intervention group ( n = 7 ) was home and for control group ( n = 7 ) was clinic . Measures were conducted pre , post and 3 months after treatment period by pediatrics motor activity log and subtests 5 ( upper limb coordination ) and 8 ( upper limb speed and dexterity ) of Bruininks – Oseretsky test of motor proficiency . Sample r and omization and data analysis by analysis of variance with repeated measures were conducted by SPSS-16 software in α level set at p < 0.05 . Results : All subjects showed significant improvement ( p < 0.01 ) in post-test measures except subtest 5 of Bruininks – Oseretsky test of motor proficiency . In contrast to clinic group , subjects in home showed significantly continued improvement at follow-up session in all measures . Conclusions : Modified CIMT is effective in improving upper limb function in children with spastic hemiplegic cerebral palsy . In addition , more improved performance in home group places the practice in natural context as the preferred method for treatment of these children . Implication s for Rehabilitation In hemiplegic cerebral palsy , one side of the body is more affected , which is a consequence of non-progressive impairments in the brain . Constraint-induced movement therapy tries to improve upper limb function of hemiparetic children by restraint of the less-affected h and and intensive training of the more-affected h and . This study shows more improvement of h and function through implementing constraint-induced movement therapy in home than clinic . In a r and omized , controlled trial , our study shows the positive effects of practice in natural environments compared to simulated environments such as clinic OBJECTIVE To delineate characteristics of best responders in a r and omized trial comparing constraint-induced movement therapy ( CIMT ) to bimanual training for children with unilateral cerebral palsy . DESIGN Secondary analysis of a single-blind matched-pairs r and omized comparison trial . SETTING Community sporting facilities in 2 Australian capital cities . PARTICIPANTS Children ( n=64 ; mean age , 10.2±2.7y ; 52 % boys ) , matched for age , sex , side of hemiplegia , and upper-limb function , were r and omized within pairs to CIMT or bimanual training .  Sixty-one children who completed CIMT ( n=31 ) or b 
    Output:
    