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 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 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 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 bimanual training ( n=30 ) were included in this study . INTERVENTIONS Each intervention was delivered in day camps ( total 60h over 10d ) using a novel circus theme with goal -directed training . MAIN OUTCOME MEASURES Change between baseline , 3 , and 26 weeks on the Melbourne Assessment of Unilateral Upper Limb Function ( MUUL>7.4 % ) , Assisting H and Assessment ( AHA>4 raw score points ) , and Canadian Occupational Performance Measure ( COPM>2 points ) defined best responders . RESULTS Poorer baseline h and function predicted a best response for unimanual capacity of the impaired upper limb ( MUUL ) immediately postintervention ; however , at 26 weeks the odds of achieving a favorable outcome were 21 times greater for CIMT than bimanual training . A favorable response for bimanual performance ( AHA ) was predicted by immediate change in Jebsen-Taylor h and function test scores . Age ( older ) , left-sided hemiplegia , and lower-baseline COPM performance scores significantly predicted favorable individualized outcomes . CONCLUSIONS Secondary analysis of a r and omized trial directly comparing 2 upper-limb training models , found children with poorer h and function benefited most . Favorable outcomes for bimanual performance were associated with gains in movement efficiency and older children with left-sided hemiplegia achieved more favorable gains in perceived occupational performance UNLABELLED The aim was to evaluate the effect of Eco-CIMT in young children with unilateral cerebral palsy in a r and omized controlled crossover design . The training was implemented within the regular pediatric services , provided by the child 's parents and /or preschool teacher and supervised by the child 's regular therapist . METHODS Twenty-five children ( mean age 28.8 months [ SD 11.2 ] , 72 % male ) participated .  Assisting H and Assessment ( AHA ) was used as the outcome measure . The Eco-CIMT was provided for 2h a day over a period of two months . Children were r and omized into two groups and started either with Eco-CIMT or as controls with a four-month washout period before crossing over . RESULT A significant effect of Eco-CIMT  was found when compared to the control period , and the estimated treatment effect was 5.47 ( 95 % C.I. 2.93 - 8.02 ) ( including both Group 1 and Group 2 ) ( p < 0.001 ) . The non-significant estimated carryover effect allowed us to collapse the two groups based on estimates from the ANOVA model . No clear relationship to hours of training , age or general attitudes of mastery was found . CONCLUSION Eco-CIMT influenced development more than ordinary treatment at this age when Eco-CIMT was performed by parents and preschool teachers supervised by the child 's ordinary therapist PURPOSE The objective of this r and omized single blind ( outcome assessor ) controlled trial was to evaluate the efficacy of 4 weeks of modified constraint induced movement therapy ( mCIMT ) in improving upper limb function in 3 - 8 years old children with hemiplegic cerebral palsy . METHODS Thirty-one children were r and omly assigned to receive the mCIMT ( N=16 ) with conventional therapy or conventional therapy alone ( N=15 ) . Children were evaluated three times ( at enrollment , follow up at 4 weeks and 12 weeks ) . The primary outcome measure was difference in " change in mean total QUEST scores " at 4 weeks of intervention between the intervention and the control arm . RESULTS After 4 weeks of intervention , mCIMT group showed significant change in the affected upper limb in QUEST scores ( 10.7 ± 5.2 vs 1.4 ± 1.7 , p<0.001 ) and time ( s ) to complete nine-hole-pegboard test compared with control group [ 60(0 - 130 ) vs 5(-12 to 30 ) , p<0.001 ] . The improvement observed in upper limb function after 4 weeks of intervention persisted 8 weeks after discontinuation of intervention in mCIMT group . CONCLUSION The modified constraint induced movement therapy appears to be effective in improving upper limb function in 3 - 8 years old hemiplegic cerebral palsy children 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 AIM Constraint-induced movement therapy ( CIT ) is a rehabilitation intervention put forward by Taub and colleagues for sensorimotor disorders in children with hemiparesis , comprising consisting of the restraint of the unaffected arm and concurrent intensive training of the affected arm for six hours/day for two weeks . The aim of this study was to evaluate the effectiveness of a modified CIT program ( m 
    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 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 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 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 bimanual training ( n=30 ) were included in this study . INTERVENTIONS Each intervention was delivered in day camps ( total 60h over 10d ) using a novel circus theme with goal -directed training . MAIN OUTCOME MEASURES Change between baseline , 3 , and 26 weeks on the Melbourne Assessment of Unilateral Upper Limb Function ( MUUL>7.4 % ) , Assisting H and Assessment ( AHA>4 raw score points ) , and Canadian Occupational Performance Measure ( COPM>2 points ) defined best responders . RESULTS Poorer baseline h and function predicted a best response for unimanual capacity of the impaired upper limb ( MUUL ) immediately postintervention ; however , at 26 weeks the odds of achieving a favorable outcome were 21 times greater for CIMT than bimanual training . A favorable response for bimanual performance ( AHA ) was predicted by immediate change in Jebsen-Taylor h and function test scores . Age ( older ) , left-sided hemiplegia , and lower-baseline COPM performance scores significantly predicted favorable individualized outcomes . CONCLUSIONS Secondary analysis of a r and omized trial directly comparing 2 upper-limb training models , found children with poorer h and function benefited most . Favorable outcomes for bimanual performance were associated with gains in movement efficiency and older children with left-sided hemiplegia achieved more favorable gains in perceived occupational performance UNLABELLED The aim was to evaluate the effect of Eco-CIMT in young children with unilateral cerebral palsy in a r and omized controlled crossover design . The training was implemented within the regular pediatric services , provided by the child 's parents and /or preschool teacher and supervised by the child 's regular therapist . METHODS Twenty-five children ( mean age 28.8 months [ SD 11.2 ] , 72 % male ) participated .  Assisting H and Assessment ( AHA ) was used as the outcome measure . The Eco-CIMT was provided for 2h a day over a period of two months . Children were r and omized into two groups and started either with Eco-CIMT or as controls with a four-month washout period before crossing over . RESULT A significant effect of Eco-CIMT  was found when compared to the control period , and the estimated treatment effect was 5.47 ( 95 % C.I. 2.93 - 8.02 ) ( including both Group 1 and Group 2 ) ( p < 0.001 ) . The non-significant estimated carryover effect allowed us to collapse the two groups based on estimates from the ANOVA model . No clear relationship to hours of training , age or general attitudes of mastery was found . CONCLUSION Eco-CIMT influenced development more than ordinary treatment at this age when Eco-CIMT was performed by parents and preschool teachers supervised by the child 's ordinary therapist PURPOSE The objective of this r and omized single blind ( outcome assessor ) controlled trial was to evaluate the efficacy of 4 weeks of modified constraint induced movement therapy ( mCIMT ) in improving upper limb function in 3 - 8 years old children with hemiplegic cerebral palsy . METHODS Thirty-one children were r and omly assigned to receive the mCIMT ( N=16 ) with conventional therapy or conventional therapy alone ( N=15 ) . Children were evaluated three times ( at enrollment , follow up at 4 weeks and 12 weeks ) . The primary outcome measure was difference in " change in mean total QUEST scores " at 4 weeks of intervention between the intervention and the control arm . RESULTS After 4 weeks of intervention , mCIMT group showed significant change in the affected upper limb in QUEST scores ( 10.7 ± 5.2 vs 1.4 ± 1.7 , p<0.001 ) and time ( s ) to complete nine-hole-pegboard test compared with control group [ 60(0 - 130 ) vs 5(-12 to 30 ) , p<0.001 ] . The improvement observed in upper limb function after 4 weeks of intervention persisted 8 weeks after discontinuation of intervention in mCIMT group . CONCLUSION The modified constraint induced movement therapy appears to be effective in improving upper limb function in 3 - 8 years old hemiplegic cerebral palsy children 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 AIM Constraint-induced movement therapy ( CIT ) is a rehabilitation intervention put forward by Taub and colleagues for sensorimotor disorders in children with hemiparesis , comprising consisting of the restraint of the unaffected arm and concurrent intensive training of the affected arm for six hours/day for two weeks . The aim of this study was to evaluate the effectiveness of a modified CIT program ( m 
    Output:
    