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 journalArticle

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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