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: Abstract Purpose : To investigate the impact of mastery motivation on occupational performance outcomes immediately following upper limb ( UL ) training and 6 months post-intervention for school-aged children with unilateral cerebral palsy . Method : This prediction study was a post-hoc analysis of a matched pairs r and omized comparison trial ( COMBiT Trial Registration : ACTRN12613000181707 ) . The Canadian Occupational Performance Measure ( COPM ) was administered at baseline , 13 and 26 weeks post-intervention . Parents completed the Dimensions of Mastery Question naire ( DMQ ) , Parenting Scale and a demographic question naire . Children ’s UL capacity and performance was assessed using the Melbourne Assessment of Unilateral UL Function and assisting h and assessment ( AHA ) . Regression models were fitted using generalized estimating equations to baseline , 13 and 26 week measurements . Results : Forty-six children ( 7.78 years SD 2.27 years , 31 males , Manual Ability Classification System I = 23 , II = 23 ) participated . Higher levels of bimanual performance ( AHA : β = 0.03 , p < 0.001 ) , greater object-oriented persistence ( DMQ : β = 0.31 , p = 0.05 ) , and treatment group allocation ( St and ard Care : β = 0.24 , p = 0.01 ) were positively associated with COPM performance scores post-intervention . Conclusions : Children ’s bimanual performance and persistence with object-oriented tasks significantly impact occupational performance outcomes following UL training . Predetermining children ’s mastery motivation along with bimanual ability may assist in tailoring of intervention strategies and models of service delivery to improve effectiveness . Implication s for Rehabilitation Children ’s object persistence and bimanual performance both impact upper limb training outcomes Working with children ’s motivational predispositions may optimize engagement and therapy outcomes . Supporting positive parenting styles may enhance a child ’s mastery motivation and persistence with difficult tasks Objective : This study aims at determining the effectiveness of constraint induced movement therapy as compared to bimanual therapy for improving functional status in children with hemiplegic cerebral palsy . Methods : This study was a r and omized control trial , children ( n = 20 ) with spastic hemiplegic cerebral palsy was r and omly allocated to CIMT ( constraint induced movement therapy ) and BMT ( bimanual therapy ) group . The children with spastic hemiplegia , age between 1.5 and 12 year and having 10 degrees of wrist extension and 10 degrees of finger extension were included in study . Treatment regime was two hours of daily training six days a week for two weeks . Constraint was applied to CIMT group for six hours . The outcome tool QUEST was used for baseline and post treatment assessment . Result : CIMT had superior outcome as compared to BMT in improving functional status ( p=0.007 ) . On QUEST tool grasp and dissociated movements results were significant ( p=0.005 ) and ( p=0.028 ) respectively . Weight bearing and protective extension result ed in no significant outcome ( p=0.080 ) and ( p=0.149 ) respectively . Dissociated movements and grasp are significantly improved but there is no difference for weight bearing and protective extension in CIMT treated group as compared to BMT treated group . Conclusion : CIMT approach is better in improving functional status of child with cerebral palsy as compared to BMT . Significant improvement in grasp and dissociated movement is noted in group of CIMT while there was no significant improvement in weight bearing and protective extension in CIMT group when compared to BMT . CIMT is considered the appropriate treatment approach for unilateral conditions while BMT for bilateral conditions 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 Overwhelming evidence shows the quality of reporting of r and omised controlled trials ( RCTs ) is not optimal . Without transparent reporting , readers can not judge the reliability and validity of trial findings nor extract information for systematic review s. Recent method ological analyses indicate that inadequate reporting and design are associated with biased estimates of treatment effects . Such systematic error is seriously damaging to RCTs , which are considered the gold st and ard for evaluating interventions because of their ability to minimise or avoid bias . A group of scientists and editors developed the CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to improve the quality of reporting of RCTs . It was first published in 1996 and up date d in 2001 . The statement consists of a checklist and flow diagram that authors can use for reporting an RCT . Many leading medical journals and major international editorial groups have endorsed the CONSORT statement . The statement facilitates critical appraisal and interpretation of RCTs . During the 2001 CONSORT revision , it became clear that explanation and elaboration of the principles underlying the CONSORT statement would help investigators and others to write or appraise trial reports . A CONSORT explanation and elaboration article was published in 2001 alongside the 2001 version of the CONSORT statement . After an expert meeting in January 2007 , the CONSORT statement has been further revised and is published as the CONSORT 2010 Statement . This up date improves the wording and clarity of the previous checklist and incorporates recommendations related to topics that have only recently received recognition , such as selective outcome reporting bias . This explanatory and elaboration document-intended to enhance the use , underst and ing , and dissemination of the CONSORT statement-has also been extensively revised . It presents the meaning and rationale for each new and up date d checklist item providing examples of good reporting and , where possible , references to relevant empirical studies . Several examples of flow diagrams are included . The CONSORT 2010 Statement , this revised explanatory and elaboration document , and the associated website ( www.consort-statement.org ) should be helpful re sources to improve reporting of r and omised trials AIM To determine whether short-term intensive group-based therapy combining modified constraint-induced movement therapy and bimanual therapy ( hybrid-CIMT ) is more effective than an equal total dose of distributed individualized occupational therapy ( st and ard care ) on upper limb motor and individualized outcomes . METHOD Fifty-three children with unilateral cerebral palsy ( 69 % males ; mean age 7y 10mo , SD 2y 4mo ; Manual Ability Classification System level I , n=24 ; level II , n=23 ) were r and omly allocated , and 44 received either hybrid-CIMT  ( n=25 ) or st and ard care ( n=19 ) . St and ard care comprised six weekly occupational therapy sessions and a 12-week home programme . Outcomes were assessed at baseline , 13 weeks , and 26 weeks after treatment . RESULTS Groups were equivalent at baseline . St and ard care achieved greater gains on satisfaction with occupational performance after intervention ( estimated mean difference -1.2 , 95 % CI -2.2 to -0.1 ; p=0.04 ) and Assisting H and Assessment at 26 weeks ( estimated mean difference 3.1 , 95 % CI 0.2 - 6.0 ; p=0.04 ) . Both groups demonstrated significant improvements in dexterity of the impaired upper limb , and bimanual and occupational performance over time . The differences between groups were not clinical ly meaningful . INTERPRETATION There were no differences between the two models of therapy delivery . Group-based intensive camps may not be readily available ; however , individualized st and ard care augmented with a home programme may offer an effective alternative but needs to be provided at a sufficient dose This study aims to compare in hemiplegic children the effectiveness of intensive training ( unimanual and bimanual ) versus st and ard treatment in improving h and function , assessing the persistence after 6 months . A multicenter , prospect i ve , cluster-r and omized controlled clinical trial was design ed comparing 2 groups of children with hemiplegic cerebral palsy , treated for 10 weeks ( 3 h/d 7 d/wk ; first with unimanual constraint-induced movement therapy  , second with intensive bimanual training ) with a st and ard treatment group . Children were assessed before and after treatment and at 3 and 6 months postintervention using Quality of Upper Extremity Skills Test ( QUEST ) and Besta Scales .  One hundred five children were recruited ( 39 constraint-induced movement therapy , 33 intensive bimanual training , 33 st and ard treatment )  . Constraint-induced movement therapy and intensive bimanual training groups had significantly improved h and function , showing constant increase in time . Grasp improved immediately and significantly with constraint-induced movement therapy , and with bimanual training grasp improved gradually , reaching the same result . In both , spontaneous h and use increased in long-term assessment OBJECTIVE We compared children 's self-care performance and caregivers ' perception of children 's performance on functional goals established for children with hemiplegic cerebral palsy ( CP ) after unimanual constraint-induced movement therapy ( CIMT ) or h and -arm bimanual intensive training ( HABIT ) . METHOD Sixteen children with CP were r and omized to the CIMT or HABIT group . Interventions lasted for 15 days , 6 hr/day , totaling 90 hr . We used the Pediatric Evaluation of Disability Inventory and the Canadian Occupational Performance Measure ( COPM ) to assess the children 's daily functioning and mixed analyses of variance to compare group means on functional test scores before and after intervention . RESULTS Both groups showed significant improvements on functional measures . Group × Assessment interaction in COPM performance revealed greater improvements for the HABIT group after intervention ( p = .04 ) . CONCLUSION The results suggest that specificity of training exists only for performance of specific goals established by parents and that both CIMT and HABIT can be used to increase children 's daily functioning The aim of this prospect i ve study was to determine the outcome of affected h and impairment and disability in a group of 31 children ( 16 males , 15 females ) with hemiplegic cerebral palsy who were referred consecutively to our rehabilitation service and followed from a mean age of 2 years and 7 months to a mean age of 12 years and 9 months . The h and function assessment protocol consisted of video-recorded procedures : one to assess grip and the other to assess the extent of spontaneous use of the affected h and . Assessment s at outset and at latest follow-up showed that the series as a whole had greater h and impairment in spontaneous manipulation than in gripping tasks . Comparison of h and function before age 4 years with the latest assessment over age 11 years revealed a non-significant improvement in grip , whereas spontaneous h and use remained stable . All but one of the children who had good grip and h and use scores at first assessment maintained them over time unless they were not treated for h and dysfunction . Among the children with low scores at outset , the improvement over time was more marked in grip than spontaneous h and use and occurred mainly in the early years . These results suggest that to evaluate the real disability of the affected h and in children with hemiplegia , grip assessment is insufficient and that an instrument assessing spontaneous h and use in bilateral manipulation is required . Furthermore , intensive treatment focused on h and function should be planned in the early years for children with more severe h and impairment , whereas regular follow-up is sufficient for less affected children Objective : To evaluate the effects of constraint-induced movement therapy on the use of the affected arm and on daily functioning in children with hemiplegic cerebral palsy . Design : A single-blinded r and omized clinical trial . Subjects : Sixteen children with cerebral palsy r and omized to intervention ( n = 8 , 4 males , 4 females , mean age 5 years and 6 months ) and control groups ( n = 8 , 4 males , 4 females , mean age 6 years and 7 months ) . Interventions : Non-affected arm of intervention group was restricted for 10 hours/ day and the affected arm intensively trained for 3 hours/day for two weeks . The intervention protocol included one week of bimanual functional training following constraint therapy . The control group maintained usual rehabilitation throughout the intervention 
    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: Abstract Purpose : To investigate the impact of mastery motivation on occupational performance outcomes immediately following upper limb ( UL ) training and 6 months post-intervention for school-aged children with unilateral cerebral palsy . Method : This prediction study was a post-hoc analysis of a matched pairs r and omized comparison trial ( COMBiT Trial Registration : ACTRN12613000181707 ) . The Canadian Occupational Performance Measure ( COPM ) was administered at baseline , 13 and 26 weeks post-intervention . Parents completed the Dimensions of Mastery Question naire ( DMQ ) , Parenting Scale and a demographic question naire . Children ’s UL capacity and performance was assessed using the Melbourne Assessment of Unilateral UL Function and assisting h and assessment ( AHA ) . Regression models were fitted using generalized estimating equations to baseline , 13 and 26 week measurements . Results : Forty-six children ( 7.78 years SD 2.27 years , 31 males , Manual Ability Classification System I = 23 , II = 23 ) participated . Higher levels of bimanual performance ( AHA : β = 0.03 , p < 0.001 ) , greater object-oriented persistence ( DMQ : β = 0.31 , p = 0.05 ) , and treatment group allocation ( St and ard Care : β = 0.24 , p = 0.01 ) were positively associated with COPM performance scores post-intervention . Conclusions : Children ’s bimanual performance and persistence with object-oriented tasks significantly impact occupational performance outcomes following UL training . Predetermining children ’s mastery motivation along with bimanual ability may assist in tailoring of intervention strategies and models of service delivery to improve effectiveness . Implication s for Rehabilitation Children ’s object persistence and bimanual performance both impact upper limb training outcomes Working with children ’s motivational predispositions may optimize engagement and therapy outcomes . Supporting positive parenting styles may enhance a child ’s mastery motivation and persistence with difficult tasks Objective : This study aims at determining the effectiveness of constraint induced movement therapy as compared to bimanual therapy for improving functional status in children with hemiplegic cerebral palsy . Methods : This study was a r and omized control trial , children ( n = 20 ) with spastic hemiplegic cerebral palsy was r and omly allocated to CIMT ( constraint induced movement therapy ) and BMT ( bimanual therapy ) group . The children with spastic hemiplegia , age between 1.5 and 12 year and having 10 degrees of wrist extension and 10 degrees of finger extension were included in study . Treatment regime was two hours of daily training six days a week for two weeks . Constraint was applied to CIMT group for six hours . The outcome tool QUEST was used for baseline and post treatment assessment . Result : CIMT had superior outcome as compared to BMT in improving functional status ( p=0.007 ) . On QUEST tool grasp and dissociated movements results were significant ( p=0.005 ) and ( p=0.028 ) respectively . Weight bearing and protective extension result ed in no significant outcome ( p=0.080 ) and ( p=0.149 ) respectively . Dissociated movements and grasp are significantly improved but there is no difference for weight bearing and protective extension in CIMT treated group as compared to BMT treated group . Conclusion : CIMT approach is better in improving functional status of child with cerebral palsy as compared to BMT . Significant improvement in grasp and dissociated movement is noted in group of CIMT while there was no significant improvement in weight bearing and protective extension in CIMT group when compared to BMT . CIMT is considered the appropriate treatment approach for unilateral conditions while BMT for bilateral conditions 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 Overwhelming evidence shows the quality of reporting of r and omised controlled trials ( RCTs ) is not optimal . Without transparent reporting , readers can not judge the reliability and validity of trial findings nor extract information for systematic review s. Recent method ological analyses indicate that inadequate reporting and design are associated with biased estimates of treatment effects . Such systematic error is seriously damaging to RCTs , which are considered the gold st and ard for evaluating interventions because of their ability to minimise or avoid bias . A group of scientists and editors developed the CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to improve the quality of reporting of RCTs . It was first published in 1996 and up date d in 2001 . The statement consists of a checklist and flow diagram that authors can use for reporting an RCT . Many leading medical journals and major international editorial groups have endorsed the CONSORT statement . The statement facilitates critical appraisal and interpretation of RCTs . During the 2001 CONSORT revision , it became clear that explanation and elaboration of the principles underlying the CONSORT statement would help investigators and others to write or appraise trial reports . A CONSORT explanation and elaboration article was published in 2001 alongside the 2001 version of the CONSORT statement . After an expert meeting in January 2007 , the CONSORT statement has been further revised and is published as the CONSORT 2010 Statement . This up date improves the wording and clarity of the previous checklist and incorporates recommendations related to topics that have only recently received recognition , such as selective outcome reporting bias . This explanatory and elaboration document-intended to enhance the use , underst and ing , and dissemination of the CONSORT statement-has also been extensively revised . It presents the meaning and rationale for each new and up date d checklist item providing examples of good reporting and , where possible , references to relevant empirical studies . Several examples of flow diagrams are included . The CONSORT 2010 Statement , this revised explanatory and elaboration document , and the associated website ( www.consort-statement.org ) should be helpful re sources to improve reporting of r and omised trials AIM To determine whether short-term intensive group-based therapy combining modified constraint-induced movement therapy and bimanual therapy ( hybrid-CIMT ) is more effective than an equal total dose of distributed individualized occupational therapy ( st and ard care ) on upper limb motor and individualized outcomes . METHOD Fifty-three children with unilateral cerebral palsy ( 69 % males ; mean age 7y 10mo , SD 2y 4mo ; Manual Ability Classification System level I , n=24 ; level II , n=23 ) were r and omly allocated , and 44 received either hybrid-CIMT  ( n=25 ) or st and ard care ( n=19 ) . St and ard care comprised six weekly occupational therapy sessions and a 12-week home programme . Outcomes were assessed at baseline , 13 weeks , and 26 weeks after treatment . RESULTS Groups were equivalent at baseline . St and ard care achieved greater gains on satisfaction with occupational performance after intervention ( estimated mean difference -1.2 , 95 % CI -2.2 to -0.1 ; p=0.04 ) and Assisting H and Assessment at 26 weeks ( estimated mean difference 3.1 , 95 % CI 0.2 - 6.0 ; p=0.04 ) . Both groups demonstrated significant improvements in dexterity of the impaired upper limb , and bimanual and occupational performance over time . The differences between groups were not clinical ly meaningful . INTERPRETATION There were no differences between the two models of therapy delivery . Group-based intensive camps may not be readily available ; however , individualized st and ard care augmented with a home programme may offer an effective alternative but needs to be provided at a sufficient dose This study aims to compare in hemiplegic children the effectiveness of intensive training ( unimanual and bimanual ) versus st and ard treatment in improving h and function , assessing the persistence after 6 months . A multicenter , prospect i ve , cluster-r and omized controlled clinical trial was design ed comparing 2 groups of children with hemiplegic cerebral palsy , treated for 10 weeks ( 3 h/d 7 d/wk ; first with unimanual constraint-induced movement therapy  , second with intensive bimanual training ) with a st and ard treatment group . Children were assessed before and after treatment and at 3 and 6 months postintervention using Quality of Upper Extremity Skills Test ( QUEST ) and Besta Scales .  One hundred five children were recruited ( 39 constraint-induced movement therapy , 33 intensive bimanual training , 33 st and ard treatment )  . Constraint-induced movement therapy and intensive bimanual training groups had significantly improved h and function , showing constant increase in time . Grasp improved immediately and significantly with constraint-induced movement therapy , and with bimanual training grasp improved gradually , reaching the same result . In both , spontaneous h and use increased in long-term assessment OBJECTIVE We compared children 's self-care performance and caregivers ' perception of children 's performance on functional goals established for children with hemiplegic cerebral palsy ( CP ) after unimanual constraint-induced movement therapy ( CIMT ) or h and -arm bimanual intensive training ( HABIT ) . METHOD Sixteen children with CP were r and omized to the CIMT or HABIT group . Interventions lasted for 15 days , 6 hr/day , totaling 90 hr . We used the Pediatric Evaluation of Disability Inventory and the Canadian Occupational Performance Measure ( COPM ) to assess the children 's daily functioning and mixed analyses of variance to compare group means on functional test scores before and after intervention . RESULTS Both groups showed significant improvements on functional measures . Group × Assessment interaction in COPM performance revealed greater improvements for the HABIT group after intervention ( p = .04 ) . CONCLUSION The results suggest that specificity of training exists only for performance of specific goals established by parents and that both CIMT and HABIT can be used to increase children 's daily functioning The aim of this prospect i ve study was to determine the outcome of affected h and impairment and disability in a group of 31 children ( 16 males , 15 females ) with hemiplegic cerebral palsy who were referred consecutively to our rehabilitation service and followed from a mean age of 2 years and 7 months to a mean age of 12 years and 9 months . The h and function assessment protocol consisted of video-recorded procedures : one to assess grip and the other to assess the extent of spontaneous use of the affected h and . Assessment s at outset and at latest follow-up showed that the series as a whole had greater h and impairment in spontaneous manipulation than in gripping tasks . Comparison of h and function before age 4 years with the latest assessment over age 11 years revealed a non-significant improvement in grip , whereas spontaneous h and use remained stable . All but one of the children who had good grip and h and use scores at first assessment maintained them over time unless they were not treated for h and dysfunction . Among the children with low scores at outset , the improvement over time was more marked in grip than spontaneous h and use and occurred mainly in the early years . These results suggest that to evaluate the real disability of the affected h and in children with hemiplegia , grip assessment is insufficient and that an instrument assessing spontaneous h and use in bilateral manipulation is required . Furthermore , intensive treatment focused on h and function should be planned in the early years for children with more severe h and impairment , whereas regular follow-up is sufficient for less affected children Objective : To evaluate the effects of constraint-induced movement therapy on the use of the affected arm and on daily functioning in children with hemiplegic cerebral palsy . Design : A single-blinded r and omized clinical trial . Subjects : Sixteen children with cerebral palsy r and omized to intervention ( n = 8 , 4 males , 4 females , mean age 5 years and 6 months ) and control groups ( n = 8 , 4 males , 4 females , mean age 6 years and 7 months ) . Interventions : Non-affected arm of intervention group was restricted for 10 hours/ day and the affected arm intensively trained for 3 hours/day for two weeks . The intervention protocol included one week of bimanual functional training following constraint therapy . The control group maintained usual rehabilitation throughout the intervention 
    Output:
    