{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T21:32:21Z","timestamp":1789075941436,"version":"build-2803163510"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,8,21]],"date-time":"2013-08-21T00:00:00Z","timestamp":1377043200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of this study was to determine the feasibility and efficacy of five treatments of 6\u00a0Hz primed, low\u2010frequency, repetitive transcranial magnetic stimulation (r<jats:styled-content style=\"fixed-case\">TMS<\/jats:styled-content>) combined with constraint\u2010induced movement therapy (<jats:styled-content style=\"fixed-case\">CIMT<\/jats:styled-content>) to promote recovery of the paretic hand in children with congenital hemiparesis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Nineteen children with congenital hemiparesis aged between 8 and 17\u00a0years (10 males, nine females; mean age 10\u00a0years 10\u00a0months, <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content> 2\u00a0years 10\u00a0months; <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>anual <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>bility <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>lassification <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>cale levels <jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">III<\/jats:styled-content>) underwent five sessions of either real r<jats:styled-content style=\"fixed-case\">TMS<\/jats:styled-content> (<jats:italic>n<\/jats:italic>=10) or sham r<jats:styled-content style=\"fixed-case\">TMS<\/jats:styled-content> (<jats:italic>n<\/jats:italic>=9) alternated daily with <jats:styled-content style=\"fixed-case\">CIMT<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">CIMT<\/jats:styled-content> consisted of 13\u00a0days of continuous long\u2010arm casting with five skin\u2010check sessions. Each child received a total of 10\u00a0hours of one\u2010to\u2010one therapy. The primary outcome measure was the <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>ssisting <jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>and <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>ssessment (<jats:styled-content style=\"fixed-case\">AHA<\/jats:styled-content>) and the secondary outcome variables were the <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>anadian <jats:styled-content style=\"fixed-case\">O<\/jats:styled-content>ccupational <jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>erformance <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>easure (<jats:styled-content style=\"fixed-case\">COPM<\/jats:styled-content>) and stereognosis. A <jats:styled-content style=\"fixed-case\">W<\/jats:styled-content>ilcoxon signed\u2010rank sum test was used to analyze differences between pre\u2010 and post\u2010test scores within the groups. Analysis of covariance was used to compute mean differences between groups adjusting for baseline. Fisher's exact test was used to compare individual change in <jats:styled-content style=\"fixed-case\">AHA<\/jats:styled-content> raw scores with the smallest detectable difference (<jats:styled-content style=\"fixed-case\">SDD<\/jats:styled-content>) of 4 points.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All participants receiving treatment finished the study. Improvement in <jats:styled-content style=\"fixed-case\">AHA<\/jats:styled-content> differed significantly between groups (<jats:italic>p<\/jats:italic>=0.007). No significant differences in the secondary outcome measures were found. Eight out of 10 participants in the r<jats:styled-content style=\"fixed-case\">TMS<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">CIMT<\/jats:styled-content> group showed improvement greater than the <jats:styled-content style=\"fixed-case\">SDD<\/jats:styled-content>, but only two out of nine in the sham r<jats:styled-content style=\"fixed-case\">TMS<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">CIMT<\/jats:styled-content> group showed such improvement (<jats:italic>p<\/jats:italic>=0.023). No serious adverse events occurred.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Primed, low\u2010frequency r<jats:styled-content style=\"fixed-case\">TMS<\/jats:styled-content> combined with <jats:styled-content style=\"fixed-case\">CIMT<\/jats:styled-content> appears to be safe, feasible, and efficacious in pediatric hemiparesis. Larger clinical trials are now indicated.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dmcn.12243","type":"journal-article","created":{"date-parts":[[2013,8,21]],"date-time":"2013-08-21T06:06:42Z","timestamp":1377065202000},"page":"44-52","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":99,"title":["Primed low\u2010frequency repetitive transcranial magnetic stimulation and constraint\u2010induced movement therapy in pediatric hemiparesis: a randomized controlled trial"],"prefix":"10.1111","volume":"56","author":[{"given":"Bernadette T","family":"Gillick","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation University of Minnesota Minneapolis MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda E","family":"Krach","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation University of Minnesota Minneapolis MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Feyma","sequence":"additional","affiliation":[{"name":"Pediatric Neurology Gillette Children's Specialty Healthcare Saint Paul MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tonya L","family":"Rich","sequence":"additional","affiliation":[{"name":"Occupational Therapy Gillette Children's Specialty Healthcare Saint Paul MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelli","family":"Moberg","sequence":"additional","affiliation":[{"name":"Occupational Therapy Gillette Children's Specialty Healthcare Saint Paul MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Thomas","sequence":"additional","affiliation":[{"name":"Division of Biostatistics School of Public Health University of Minnesota Minneapolis MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica 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