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.

Journal of child neurology (Impact Factor: 1.59). 05/2012; DOI: 10.1177/0883073812443004
Source: PubMed

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.

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    ABSTRACT: Children with cerebral palsy have variable medical and developmental needs, which impact their ability to grow and function independently. Therapy interventions for fine motor skills, speech and mobility skills can be of benefit. The importance of optimizing vision, hearing, nutrition, and spasticity control also impacts learning, growth and function as well as reducing secondary complications such as fractures. This article reviews recent literature for clinical updates that impact these areas.
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