Tasos Karakostas

hirley Ryan AbilityLab and Northwestern University, USA

Abstract Title:

Constraint-induced movement therapy for children with Brachial Plexus Injury: Upper and Lower extremity changes

Biography:

Dr. Karakostas hold a Masters in Biomechanics from Michigan State University, a Masters in Physical Therapy, from Texas Tech University a PhD in Biomedical Engineering from the Ohio State University and an MBA from the University of Iowa. He has over 50 peer reviewed publications in high impact journals and his research has been supported by foundations, the Nasional Science Foundation and the National Institute of Health. He is currently the Associate Director of the Computerized Motion Analysis laboratory at the Shirley Ryan AbilityLab (former Rehabilitation Institute of Chicago) and adjunct Professor at Northwestern University, Feinberg School of Medicine.

Research Interests:

Previously we developed a pediatric constraint induced movement therapy (pCIMT) camp to address upper extremity (UE) deficits of children with hemiplegia. We found positive outcomes in UE function and gait. The objectives of this study were to a) assess the effectiveness of a similar camp to treat children with Brachial Plexus Injury (BPI), b) determine potentially similar effects in lower extremity (LE) function, and c) determine retention. This was randomized control study including 17 children with BPI, 3-7 years old, 9 randomly assigned in the experimental group. No participant had history of other neuromusculoskeletal injury or previous CIMT exposure. We delivered 30 treatment hours over 10 days at our hospital. Activities focused on gross, fine motor and self-feeding skills. Control group participants had traditional therapy. Outcome measures included the UE Spontaneous Function (SF) and Dynamic Position (DP) based on Shriners Hospital Upper Extremity Evaluation, and LE function based on gait velocity, cadence and step length symmetry. All data was normalized. This report focuses on the experimental group pre-, post- and 6-months post-pCIMT. All parameters demonstrated statistically significant improvement (pre to post testing; p=0.02). During 6-months post-testing, while SF returned to almost pre-testing level the rest of the parameters showed no statistically significant change. This is, to our knowledge, the first randomized control study investigating the long-term effects of pCIMT on the function of UE and LE of children with BPI. The results demonstrate improvements in UE and LE function. Gains were retained after 6 months; LE gains were better retained.