ABSTRACT
Background
Perinatal stroke causes hemiparetic cerebral palsy (HCP) and lifelong disability. Constraint-induced movement therapy (CIMT) and neurostimulation may enhance motor function, but the individual factors associated with responsiveness are undetermined.
Objective
We explored the clinical and neurophysiological factors associated with responsiveness to CIMT and/or brain stimulation within a clinical trial.
Methods
PLASTIC CHAMPS was a randomized, blinded, sham-controlled trial (n = 45) of CIMT and neurostimulation paired with intensive, goal-directed therapy. Primary outcome was the Assisting Hand Assessment (AHA). Classification trees created through recursive partitioning suggested clinical and neurophysiological profiles associated with improvement at 6-months.
Results
Both clinical (stroke side (left) and age >14 years) and neurophysiological (intracortical inhibition/facilitation and motor threshold) were associated with responsiveness across treatment groups with positive predictive values (PPV) approaching 80%.
Conclusion
This preliminary analysis suggested sets of variables that may be associated with response to intensive therapies in HCP. Further modeling in larger trials is required.
Acknowledgments
We thank children and families participating in this study.
PLASTIC CHAMPS was funded by Heart and Stroke Foundation of Canada and Alberta Children’s Hospital Foundation. AK was funded by Canadian Institutes of Health Research; H-CK was funded by postdoc salary awards of Canadian Partnership for Stroke Recovery and Alberta Children’s Hospital Research Institute.
Disclosure Statement
The authors report no conflicts of interest.