Unimanual and Bimanual Intensive Training in Children With Hemiplegic Cerebral Palsy and Persistence in Time of Hand Function Improvement: 6-Month Follow-Up Results of a Multisite Clinical Trial. (February 2013)

• Record Type: Journal Article
• Authors: Fedrizzi, Ermellina; Rosa-Rizzotto, Melissa; Turconi, Anna Carla; Pagliano, Emanuela; Fazzi, Elisa; Pozza, Laura Visonà Dalla; Facchin, Paola
• Is Part Of: Journal of child neurology. Volume 28:Number 2(2013)
• Page Start: 161
• Page End: 175
• Publication Date: 2013-02
• Subjects: hemiplegic cerebral palsy -- modified constraint-induced movement therapy -- intensive bimanual training; Nervous system -- Diseases -- Periodicals; 618.928
• DOI: 10.1177/0883073812443004
• Languages: English
• ISSNs: 0883-0738

Abstract

This study aims to compare in hemiplegic children the effectiveness of intensive training (unimanual and bimanual) versus standard treatment in improving hand function, assessing the persistence after 6 months. A multicenter, prospective, cluster-randomized controlled clinical trial was designed comparing 2 groups of children with hemiplegic cerebral palsy, treated for 10 weeks (3 h/d 7 d/wk; first with unimanual constraint-induced movement therapy, second with intensive bimanual training) with a standard treatment group. Children were assessed before and after treatment and at 3 and 6 months postintervention using Quality of Upper Extremity Skills Test (QUEST) and Besta Scales. One hundred five children were recruited (39 constraint-induced movement therapy, 33 intensive bimanual training, 33 standard treatment). Constraint-induced movement therapy and intensive bimanual training groups had significantly improved hand function, showing constant increase in time. Grasp improved immediately and significantly with constraint-induced movement therapy, and with bimanual training grasp improved gradually, reaching the same result. In both, spontaneous hand use increased in long-term assessment.