Evidence map›Paper›PMID 27029628›Full record

Trial reportNeurology2016

Brain stimulation and constraint for perinatal stroke hemiparesis: The PLASTIC CHAMPS Trial.

Adam Kirton, John Andersen, Mia Herrero, Alberto Nettel-Aguirre, Lisa Carsolio, Omar Damji, Jamie Keess, Aleksandra Mineyko, Jacquie Hodge, Michael D Hill

3 registry-linked trialsOpen access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Neurology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 51 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
51citing papers in PubMed, 5 pooled it
37.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01189058 phase2 / phase3unknown statusnot on this map

Modulation of Brain Plasticity After Perinatal Stroke: The PLASTIC CHAMPS Trial

TypeinterventionalSponsorUniversity of CalgaryRan2010 to 2014Enrolled64ConditionsStroke, Cerebral PalsyArmsRepetitive Transcranial Magnetic Stimulation (rTMS), Constraint-induced movement therapy (CIMT)
NCT03453983 nacompletednot on this mapstarted 2018, after this paper: background citation

Transcranial Direct Current Stimulation (tDCS): A Therapeutic Intervention for Motor Impairments in Children With Developmental Coordination Disorder (DCD).

TypeinterventionalSponsorUniversity of CalgaryRan2018 to 2019Enrolled35ConditionsDevelopmental Coordination DisorderArmsTranscrainial Direct Current Stimulation (tDCS)
NCT04902521 naunknown statusnot on this mapstarted 2022, after this paper: background citation

Concurrent Use of Transcranial Magnetic Stimulation and Constraint Induced Movement Therapy in Children With Unilateral Cerebral Palsy: A Feasibility Study

TypeinterventionalSponsorUniversity of ManitobaRan2022 to 2023Enrolled10ConditionsCerebral PalsyArmsTranscranial magnetic stimulation, Sham Transcranial Magnetic stimulation
3 · Its place in the literature

Who cites it

51 citing papers in PubMed, 5 syntheses or guidelines pooled it, 127 citations in OpenAlex.

  1. Pooled it
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  6. Trial
  7. Safety and feasibility of transcranial direct current stimulation stratified by corticospinal organization in children with hemiparesis.European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society · 2023
    Trial
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  9. Review
  10. Article
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  13. Article
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  16. Advances in the Diagnosis and Treatment of Pediatric Arterial Ischemic Stroke.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2023
    Review
  17. Review
  18. Grand challenges in pediatric stroke.Frontiers in stroke · 2023
    Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Adam KirtonFrom the Departments of Pediatrics and Clinical Neurosciences (A.K., A.M.), Cumming School of Medicine, Alberta Children's Hospital Research Institute, University of Calgary; University of Alberta (J.A.), Glenrose Rehabilitation Hospital, Edmonton; Clinical Neurosciences (M.H., L.C.), Alberta Children's Hospital, Alberta Health Services; Department of Pediatrics (A.N.-A.) and Calgary Pediatric Stroke Program (A.K., O.D., J.K., A.M., J.H.), Alberta Children's Hospital; Hotchkiss Brain Institute (A.K., M.D.H.), Cumming School of Medicine, University of Calgary, Canada. adam.kirton@ahs.ca.
John AndersenFrom the Departments of Pediatrics and Clinical Neurosciences (A.K., A.M.), Cumming School of Medicine, Alberta Children's Hospital Research Institute, University of Calgary; University of Alberta (J.A.), Glenrose Rehabilitation Hospital, Edmonton; Clinical Neurosciences (M.H., L.C.), Alberta Children's Hospital, Alberta Health Services; Department of Pediatrics (A.N.-A.) and Calgary Pediatric Stroke Program (A.K., O.D., J.K., A.M., J.H.), Alberta Children's Hospital; Hotchkiss Brain Institute (A.K., M.D.H.), Cumming School of Medicine, University of Calgary, Canada.
Mia HerreroFrom the Departments of Pediatrics and Clinical Neurosciences (A.K., A.M.), Cumming School of Medicine, Alberta Children's Hospital Research Institute, University of Calgary; University of Alberta (J.A.), Glenrose Rehabilitation Hospital, Edmonton; Clinical Neurosciences (M.H., L.C.), Alberta Children's Hospital, Alberta Health Services; Department of Pediatrics (A.N.-A.) and Calgary Pediatric Stroke Program (A.K., O.D., J.K., A.M., J.H.), Alberta Children's Hospital; Hotchkiss Brain Institute (A.K., M.D.H.), Cumming School of Medicine, University of Calgary, Canada.
Alberto Nettel-AguirreFrom the Departments of Pediatrics and Clinical Neurosciences (A.K., A.M.), Cumming School of Medicine, Alberta Children's Hospital Research Institute, University of Calgary; University of Alberta (J.A.), Glenrose Rehabilitation Hospital, Edmonton; Clinical Neurosciences (M.H., L.C.), Alberta Children's Hospital, Alberta Health Services; Department of Pediatrics (A.N.-A.) and Calgary Pediatric Stroke Program (A.K., O.D., J.K., A.M., J.H.), Alberta Children's Hospital; Hotchkiss Brain Institute (A.K., M.D.H.), Cumming School of Medicine, University of Calgary, Canada.
Lisa CarsolioFrom the Departments of Pediatrics and Clinical Neurosciences (A.K., A.M.), Cumming School of Medicine, Alberta Children's Hospital Research Institute, University of Calgary; University of Alberta (J.A.), Glenrose Rehabilitation Hospital, Edmonton; Clinical Neurosciences (M.H., L.C.), Alberta Children's Hospital, Alberta Health Services; Department of Pediatrics (A.N.-A.) and Calgary Pediatric Stroke Program (A.K., O.D., J.K., A.M., J.H.), Alberta Children's Hospital; Hotchkiss Brain Institute (A.K., M.D.H.), Cumming School of Medicine, University of Calgary, Canada.
Omar DamjiFrom the Departments of Pediatrics and Clinical Neurosciences (A.K., A.M.), Cumming School of Medicine, Alberta Children's Hospital Research Institute, University of Calgary; University of Alberta (J.A.), Glenrose Rehabilitation Hospital, Edmonton; Clinical Neurosciences (M.H., L.C.), Alberta Children's Hospital, Alberta Health Services; Department of Pediatrics (A.N.-A.) and Calgary Pediatric Stroke Program (A.K., O.D., J.K., A.M., J.H.), Alberta Children's Hospital; Hotchkiss Brain Institute (A.K., M.D.H.), Cumming School of Medicine, University of Calgary, Canada.
Jamie KeessFrom the Departments of Pediatrics and Clinical Neurosciences (A.K., A.M.), Cumming School of Medicine, Alberta Children's Hospital Research Institute, University of Calgary; University of Alberta (J.A.), Glenrose Rehabilitation Hospital, Edmonton; Clinical Neurosciences (M.H., L.C.), Alberta Children's Hospital, Alberta Health Services; Department of Pediatrics (A.N.-A.) and Calgary Pediatric Stroke Program (A.K., O.D., J.K., A.M., J.H.), Alberta Children's Hospital; Hotchkiss Brain Institute (A.K., M.D.H.), Cumming School of Medicine, University of Calgary, Canada.
Aleksandra MineykoFrom the Departments of Pediatrics and Clinical Neurosciences (A.K., A.M.), Cumming School of Medicine, Alberta Children's Hospital Research Institute, University of Calgary; University of Alberta (J.A.), Glenrose Rehabilitation Hospital, Edmonton; Clinical Neurosciences (M.H., L.C.), Alberta Children's Hospital, Alberta Health Services; Department of Pediatrics (A.N.-A.) and Calgary Pediatric Stroke Program (A.K., O.D., J.K., A.M., J.H.), Alberta Children's Hospital; Hotchkiss Brain Institute (A.K., M.D.H.), Cumming School of Medicine, University of Calgary, Canada.
Jacquie HodgeFrom the Departments of Pediatrics and Clinical Neurosciences (A.K., A.M.), Cumming School of Medicine, Alberta Children's Hospital Research Institute, University of Calgary; University of Alberta (J.A.), Glenrose Rehabilitation Hospital, Edmonton; Clinical Neurosciences (M.H., L.C.), Alberta Children's Hospital, Alberta Health Services; Department of Pediatrics (A.N.-A.) and Calgary Pediatric Stroke Program (A.K., O.D., J.K., A.M., J.H.), Alberta Children's Hospital; Hotchkiss Brain Institute (A.K., M.D.H.), Cumming School of Medicine, University of Calgary, Canada.
Michael D HillFrom the Departments of Pediatrics and Clinical Neurosciences (A.K., A.M.), Cumming School of Medicine, Alberta Children's Hospital Research Institute, University of Calgary; University of Alberta (J.A.), Glenrose Rehabilitation Hospital, Edmonton; Clinical Neurosciences (M.H., L.C.), Alberta Children's Hospital, Alberta Health Services; Department of Pediatrics (A.N.-A.) and Calgary Pediatric Stroke Program (A.K., O.D., J.K., A.M., J.H.), Alberta Children's Hospital; Hotchkiss Brain Institute (A.K., M.D.H.), Cumming School of Medicine, University of Calgary, Canada.
University of Alberta · CAAlberta Health Services · CAAlberta Children's Hospital · CAGlenrose Rehabilitation Hospital · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine whether the addition of repetitive transcranial magnetic stimulation (rTMS) and/or constraint-induced movement therapy (CIMT) to intensive therapy increases motor function in children with perinatal stroke and hemiparesis.

methodsA factorial-design, blinded, randomized controlled trial (clinicaltrials.gov/NCT01189058) assessed rTMS and CIMT effects in hemiparetic children (aged 6-19 years) with MRI-confirmed perinatal stroke. All completed a 2-week, goal-directed, peer-supported motor learning camp randomized to daily rTMS, CIMT, both, or neither. Primary outcomes were the Assisting Hand Assessment and the Canadian Occupational Performance Measure at baseline, and 1 week, 2 and 6 months postintervention. Outcome assessors were blinded to treatment. Interim safety analyses occurred after 12 and 24 participants. Intention-to-treat analysis examined treatment effects over time (linear mixed effects model).

resultsAll 45 participants completed the trial. Addition of rTMS, CIMT, or both doubled the chances of clinically significant improvement. Assisting Hand Assessment gains at 6 months were additive and largest with rTMS + CIMT (β coefficient = 5.54 [2.57-8.51], p = 0.0004). The camp alone produced large improvements in Canadian Occupational Performance Measure scores, maximal at 6 months (Cohen d = 1.6, p = 0.002). Quality-of-life scores improved. Interventions were well tolerated and safe with no decrease in function of either hand.

conclusionsHemiparetic children participating in intensive, psychosocial rehabilitation programs can achieve sustained functional gains. Addition of CIMT and rTMS increases the chances of improvement. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that combined rTMS and CIMT enhance therapy-induced functional motor gains in children with stroke-induced hemiparetic cerebral palsy.

Indexed as

Physical Therapy ModalitiesTranscranial Magnetic StimulationAdolescentChildCombined Modality TherapyFemaleHandHumansMaleParesisPatient SelectionPsychiatric RehabilitationQuality of LifeRecovery of FunctionRestraint, PhysicalSingle-Blind Method

Identifiers

PMID27029628
PMCPMC4854585
OpenAlexW2335349608

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.