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

• Published in: Journal of child neurology Vol. 28; no. 2; p. 161
• Main Authors: Fedrizzi, Ermellina, Rosa-Rizzotto, Melissa, Turconi, Anna Carla, Pagliano, Emanuela, Fazzi, Elisa, Pozza, Laura Visonà Dalla, Facchin, Paola
• Format: Journal Article
• Language: English
• Published: United States 01.02.2013
• Subjects: Cerebral Palsy - rehabilitation; Child; Child, Preschool; Disability Evaluation; Female; Follow-Up Studies; Functional Laterality - physiology; Humans; Male; Outcome Assessment (Health Care); Physical Therapy Modalities; Restraint, Physical - methods; Severity of Illness Index; Single-Blind Method; Statistics, Nonparametric; Treatment Outcome; Upper Extremity - physiopathology
• ISSN: 1708-8283
• DOI: 10.1177/0883073812443004

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.