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

Ermellina Fedrizzi, Melissa Rosa-Rizzotto, Anna Carla Turconi, Emanuela Pagliano, Elisa Fazzi, Laura Visonà Dalla Pozza, Paola Facchin

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)161-175
Number of pages15
JournalJournal of Child Neurology
Volume28
Issue number2
DOIs
Publication statusPublished - Feb 2013

Keywords

  • hemiplegic cerebral palsy
  • intensive bimanual training
  • modified constraint-induced movement therapy

ASJC Scopus subject areas

  • Clinical Neurology
  • Pediatrics, Perinatology, and Child Health

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