Randomized trial of constraint-induced movement therapy and bimanual training on activity outcomes for children with congenital hemiplegia

Sakzewski, Leanne, Ziviani, Jenny, Abbott, David F., Macdonell, Richard A. L., Jackson, Graeme D. and Boyd, Roslyn N. (2011) Randomized trial of constraint-induced movement therapy and bimanual training on activity outcomes for children with congenital hemiplegia. Developmental Medicine & Child Neurology, 53 4: 313-320. doi:10.1111/j.1469-8749.2010.03859.x


Author Sakzewski, Leanne
Ziviani, Jenny
Abbott, David F.
Macdonell, Richard A. L.
Jackson, Graeme D.
Boyd, Roslyn N.
Title Randomized trial of constraint-induced movement therapy and bimanual training on activity outcomes for children with congenital hemiplegia
Journal name Developmental Medicine & Child Neurology   Check publisher's open access policy
ISSN 0012-1622
Publication date 2011-04-01
Year available 2011
Sub-type Article (original research)
DOI 10.1111/j.1469-8749.2010.03859.x
Open Access Status Not yet assessed
Volume 53
Issue 4
Start page 313
End page 320
Total pages 8
Place of publication United Kingdom
Publisher Mac Keith Press
Language eng
Subject 2735 Pediatrics, Perinatology, and Child Health
2806 Developmental Neuroscience
2728 Clinical Neurology
Abstract AIM To determine if constraint-induced movement therapy (CIMT) is more effective than bimanual training (BIM) in improving upper limb activity outcomes for children with congenital hemiplegia in a matched-pairs randomized trial.
Formatted abstract
Aim: To determine if constraint-induced movement therapy (CIMT) is more effective than bimanual training (BIM) in improving upper limb activity outcomes for children with congenital hemiplegia in a matched-pairs randomized trial. Method: Sixty-three children (mean age 10.2, SD 2.7, range 5-16y; 33 males, 30 females), 16 in Manual Ability Classification System level I, 46 level II, and 1 level III and 16 in Gross Motor Function Classification level I, 47 level II) were randomly allocated to either CIMT or BIM group day camps (60hours over 10days). The Melbourne Assessment of Unilateral Upper Limb Function assessed unimanual capacity of the impaired limb and Assisting Hand Assessment evaluated bimanual coordination at baseline, 3 and 26weeks, scored by blinded raters. Results: After concealed random allocation, there was no baseline difference between groups. CIMT had superior outcomes compared with BIM for unimanual capacity at 26weeks (estimated mean difference [EMD] 4.4, 95% confidence interval [CI] 2.2-6.7; p<0.001). There was no other significant difference between groups post-intervention. Both groups demonstrated significant improvements in bimanual performance at 3weeks, with gains maintained by BIM at 26weeks (EMD 2.3; 95% CI 0.6-4.0; p=0.008). Interpretation: Overall, there were only small differences between the two training approaches. CIMT yielded greater changes in unimanual capacity of the impaired upper limb compared with BIM. Results: generally reflect specificity of practice, with CIMT improving unimanual capacity and BIM improving bimanual performance. Considerable inter-individual variation in response to either intervention was evident. Future research should consider serial sequencing unimanual then BIM approaches to optimize upper limb outcomes for children with congenital hemiplegia. © The Authors. Journal compilation © Mac Keith Press 2011.
Keyword Cerebral Palsy
Hand
Reliability
Efficacy
Management
Q-Index Code C1
Q-Index Status Confirmed Code
Grant ID LS 384488
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Health and Rehabilitation Sciences Publications
School of Medicine Publications
 
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Created: Wed, 23 Mar 2011, 16:11:29 EST by Ms Leanne Sakzewski on behalf of School of Medicine