Objective To determine whether modified constraint-induced movement therapy (mCIMT) with continuous restraint is feasible and effective in improving the use of the paretic arm in the real world among infants and toddlers with unilateral cerebral palsy (CP). Design Single-blind randomized controlled trial. Setting Tertiary hospital. Participants Children aged 7 to 36 months with unilateral CP (N = 24; 16 boys, 8 girls). Intervention The experimental group received 2-hour clinic-based mCIMT sessions (5 days per week for 3 weeks), and a continuous restraint was applied. Main Outcome Measures Standardized assessments were conducted. Peabody Developmental Motor Scales-2 (PDMS-2), Gross Motor Function Measure-66, Pediatric Motor Activity Log (PMAL), and Pediatric Evaluation of Disability Inventory were measured pre- and postintervention. Children who agreed to participate in the accelerometer study additionally wore accelerometers on both their wrists for 3 days before and after the intervention. Results The mCIMT group exhibited greater improvement in PMAL-how often (p = 0.048; ηp² = 0.173), PMAL-how well (p = 0.008; ηp² = 0.289), and PDMS-2 visual motor integration (p = 0.014; ηp² = 0.256) posttreatment than the control group. The percentage of time in moderate-to-vigorous physical activity (z = –2.24; p = 0.03) and vector magnitude average counts (z = –2.52; p = 0.01) significantly increased in children in who wore accelerometers (N = 8) after the 3-week mCIMT protocol. Conclusion mCIMT with continuous restraint applied to infants and toddlers with unilateral CP appeared to have a positive effect on paretic hand use in the real world. Clinical Trial Registration Number NCT03418519

We have integrated a phase-change chalcogenide random access memory, completely based on 0.24 /spl mu/m-CMOS technologies. A twin cell and BL clamping circuits are introduced to enlarge fabrication tolerance and to reduce cell perturbation during reading operation. To draw back current as much as possible, Co salicidation is also applied to transistor formation. By constructing a simple cell structure with Ge/sub 2/Sb/sub 2/Te/sub 5/, we have observed reliable phase-transitions by driving current through MOS transistors. With 100 ns-writing pulses of 2 mA for RESET and 0.6 mA for SET, the device operates successfully with a considerable sensing signal at reading voltage of as low as 0.2 V.

To determine the potential of low-end high-intensity home-based hand-arm bimanual intensive therapy (H-HABIT) in mitigating post-modified constraint-induced movement therapy (mCIMT) regression in children with unilateral cerebral palsy (UCP). Twenty-two children (aged 4-12 years) with UCP were assigned to either the experimental (n = 12) or control group (n = 10). Both groups completed 30 h of mCIMT for three weeks, followed by 30 h of H-HABIT for five weeks in the experimental group and none in the control group. Assessments, including the assisting hand assessment (AHA) and other standardized measures, were performed at baseline, post-mCIMT, and post-H-HABIT. Triaxial accelerometers were worn on both wrists during each phase to monitor the activity. The experimental group showed AHA scores from baseline to post-H-HABIT, with a significant time × group interaction (p = 0.001, ƞ² = 0.29) indicating distinct trajectories from the control. In contrast, actigraphy-based measures of the upper limb remained stable over time. Caregiver feedback for H-HABIT showed that 83.33% found the guidelines easy to follow, and 91.67% rated therapist interactions as helpful. H-HABIT may help prevent post-mCIMT regression. Further research should refine task selection and explore advanced assessment methods to better capture real-world function.

This study aimed to elucidate the role of tri-axial accelerometers in assessing therapeutic interventions, specifically constraint-induced movement therapy (CIMT), in children with unilateral cerebral palsy (UCP). The primary focus was understanding the correlation between the actigraphy metrics recorded during CIMT sessions and the resultant therapeutic outcomes. Children with UCP, aged between 4 and 12 years, participated in this study from July 2021 to December 2022. In conjunction with in-clinic sessions, during which participants wore tri-axial accelerometers on both limbs, we analyzed actigraphy data over three days of routine activities pre- and post-CIMT. While not all metrics derived from the accelerometers indicated significant improvements post-intervention, there was a clear trend towards a more balanced usage of both limbs, particularly evident in Axis 3, associated with vertical movement (p = 0.017). Additionally, a discernible correlation was observed between changes in the magnitude ratio derived from actigraphy data during CIMT (Δweek3–week1) and variations in traditional assessments pre- and post-intervention (ΔT0–T1), specifically the Assisting Hand Assessment grasp and release. Using tri-axial accelerometers has helped clarify the potential impacts of CIMT on children with UCP. The preliminary results suggest a possible link between actigraphy metrics taken during CIMT and the subsequent therapeutic outcomes determined by standardized tests.

The Canadian Occupational Performance Measure (COPM) is a client-centered outcome measure that facilitates the prioritization of individualized interventions. Given the rising emphasis on individualized intervention in pediatric intensive care units (PICUs), this cross-sectional study aimed to explore caregivers’ perspectives on their children’s functional goals within PICUs. From 1 September 2020 to 26 June 2022, caregivers of 41 children aged 1–18 years completed the COPM within 48 h of PICU admission. The study also explored the clinical variables predicting a high number of occupational performance goals (≥4/5). Out of 190 goals proposed by caregivers, 87 (45.8%) pertained to occupational performance, while 103 (54.2%) were related to personal factors. Among the occupational performance goals, the majority were associated with functional mobility (55; 28.9%), followed by personal care (29; 15.2%) and quiet recreation (3; 1.6%). Among personal goals, physiological factors (68; 35.8%) were most common, followed by physical factors (35; 18.4%). We found caregiver anxiety, measured by the State-Trait Anxiety Inventory-State, to be a significant predictor of the number of occupational performance goals. These findings underscore the importance of caregiver psychological assessment in the PICU to facilitate personalized goal setting and improve rehabilitation outcomes.