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Effectiveness of modified constraint-induced movement therapy in children with unilateral spastic cerebral palsy: a randomized controlled trial

Effectiveness of modified constraint-induced movement therapy in children with unilateral spastic cerebral palsy: a randomized controlled trial,10.117

Effectiveness of modified constraint-induced movement therapy in children with unilateral spastic cerebral palsy: a randomized controlled trial   (Citations: 9)
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BACKGROUND: In children with unilateral spastic cerebral palsy (CP), there is only limited evidence for the effectiveness of modified constraint-induced movement therapy (mCIMT). OBJECTIVE: To investigate whether 6 weeks of mCIMT followed by 2 weeks of bimanual task-specific training (mCIMT-BiT) in children with unilateral spastic CP improves the spontaneous use of the affected limb in both qualitative and quantitative terms more than usual care (UC) of the same duration. METHODS: Children with unilateral spastic CP with Manual Ability Classification System (MACS) scores I, II, or III and aged 2.5 to 8 years were recruited and randomly allocated to either the mCIMT-BiT group (three 3-hour sessions per week: 6 weeks of mCIMT, followed by 2 weeks of task-specific training in goal-directed bimanual play and self-care activities) or to 1.5 hours of more general physical or occupational weekly plus encouragement to use the affected hand for the UC group. Primary outcome measures were the Assisting Hand Assessment and the ABILHAND-Kids. Secondary outcomes were the Melbourne Assessment of Unilateral Upper Limb Function, the Canadian Occupational Performance Measure, and the Goal Attainment Scale. RESULTS: Twenty-eight children were allocated to mCIMT-BiT and 24 to UC. Except for the Melbourne, all primary and secondary outcome measures demonstrated significant improvements in the mCIMT-BiT group. CONCLUSION: mCIMT followed by task-specific training of goal-directed bimanual play and self-care activities is an effective intervention to improve the spontaneous use of the more affected upper limb in children with relatively good baseline upper extremity function.
Journal: Neurorehabilitation and Neural Repair - NEUROREHABIL NEURAL REPAIR , vol. 24, no. 6, pp. 509-518, 2010
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    • ...Also, the scale responsiveness to change was demonstrated in intervention studies focusing on forced use therapy [47], CIMT [38,44,46,48,49], HABIT [50] and, recently, modified CIMT followed by task-specific training of goal-directed bimanual play and self-care activities [51,52]...
    • ...In a recent study where a modified CIMT followed by task-specific training of goal-directed bimanual play and self-care activities were used in children with HCP a high effect size (Cohen’s d: 1.01) was reported [46,51,52]...

    Giuseppina Sgandurraet al. Upper limb children action-observation training (UP-CAT): a randomised...

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