Studies comparing the efficacy of constraint-induced movement therapy and bimanual training in children with unilateral cerebral palsy: A systematic review

2012 ◽  
Vol 16 (2) ◽  
pp. 133-143 ◽  
Author(s):  
Vicky An-Qin Dong ◽  
Ivy Hsi-Hsuan Tung ◽  
Hester Wai-Yi Siu ◽  
Kenneth Nai-Kuen Fong
Keyword(s):  
Systematic Review ◽  
Cerebral Palsy ◽  
Movement Therapy ◽  
Constraint Induced Movement Therapy ◽  
Bimanual Training ◽  
Unilateral Cerebral Palsy

Efficacy of constraint-induced movement therapy compared with bimanual intensive training in children with unilateral cerebral palsy: a systematic review

2017 ◽  
Vol 31 (11) ◽  
pp. 1445-1456 ◽  
Author(s):  
MH Tervahauta ◽  
GL Girolami ◽  
GK Øberg
Keyword(s):  
Systematic Review ◽  
Cerebral Palsy ◽  
Meta Analysis ◽  
Movement Therapy ◽  
Effect Sizes ◽  
System Level ◽  
Cochrane Library ◽  
Intensive Training ◽  
Constraint Induced Movement Therapy ◽  
Unilateral Cerebral Palsy

Objective: To systematically review the evidence on the effect of constraint-induced movement therapy compared with bimanual intensive training in children with unilateral cerebral palsy. Data sources: Seven electronic databases (Cinahl, Cochrane Library, EMBASE, Ovid MEDLINE, PEDro, PsycINFO, PubMed) were searched from database inception through December 2016. Methods: A systematic review was performed using the American Academy of Cerebral Palsy and Developmental Medicine and Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Standardised mean differences (effect sizes) were calculated for each study and outcome. Results: Nine studies met the eligibility criteria. All studies provided level II evidence. Methodological quality was high in two studies, moderate in four studies and low in three studies. The methodology, participant and intervention characteristics were heterogeneous. The participants’ ages ranged from 1.5 to 16 years. Their initial hand function ranged from Manual Ability Classification System Level I to Level III. The total intervention dose ranged from 24 to 210 hours and duration from one week to ten weeks. The studies measured outcomes assessing unimanual and bimanual hand and arm function, participation and attainment of individualised goals. Overall, the effect sizes did not favour one of the interventions at short- or long-term follow-up. The 95% confidence intervals were broad, indicating inaccurate precision of the effect sizes. Pooling of the data for a meta-analysis was judged to be of little clinical value owing to heterogeneity. Conclusion: It is not possible to conclude whether constraint-induced movement therapy or bimanual intensive training is more effective than the other in children with unilateral cerebral palsy.

scholarly journals Bound for Success: A Systematic Review of Constraint-Induced Movement Therapy in Children With Cerebral Palsy Supports Improved Arm and Hand Use

2009 ◽  
Vol 89 (11) ◽  
pp. 1126-1141 ◽  
Author(s):  
Hsiang-han Huang ◽  
Linda Fetters ◽  
Jennifer Hale ◽  
Ashley McBride
Keyword(s):  
Systematic Review ◽  
Cerebral Palsy ◽  
Outcome Measures ◽  
Movement Therapy ◽  
The Body ◽  
Activity Level ◽  
International Classification Of Functioning ◽  
Critical Threshold ◽  
Constraint Induced Movement Therapy ◽  
Intervention Protocol

BackgroundConstraint-induced movement therapy (CIMT) is a potentially effective intervention for children with hemiplegic cerebral palsy (CP).PurposeThe objectives of this systematic review are: (1) to investigate whether CIMT is supported with valid research of its effectiveness and (2) to identify key characteristics of the child and intervention protocol associated with the effects of CIMT.Data Sources and Study SelectionA search of MEDLINE (1966 through March 2009), Entrez PubMed (1966 through March 2009), EMBASE (1980 through March 2009), CINAHL (1982 through March 2009), PsychINFO (1887 through March 2009), and Web of Science (1900 through March 2009) produced 23 relevant studies.Data Extraction and SynthesisThe 2 objectives of the review were addressed by: (1) scoring the validity and level of evidence for each study and calculating evidence-based statistics, if possible, and (2) recording and summarizing the inclusion and exclusion criteria, type and duration of constraint, intervention and study durations, and outcomes based on the International Classification of Functioning, Disability and Health (ICF).LimitationsOnly studies published in journals and in English were included in the systematic review.ConclusionsStudies varied widely in type and rigor of design; subject, constraint, and intervention characteristics; and ICF level for outcome measures. One outcome measure at the body functions and structure level and 4 outcome measures at the activity level had large and significant treatment effects (d≥.80), and these findings were from the most rigorous studies. Evidence from more-rigorous studies demonstrated an increased frequency of use of the upper extremity following CIMT for children with hemiplegic CP. The critical threshold for intensity that constitutes an adequate dose cannot be determined from the available research. Further research should include a priori power calculations, more-rigorous designs and comparisons of different components of CIMT in relation to specific children, and measures of potential impacts on the developing brain.

scholarly journals Upper limb therapy in children with cerebral palsy (CP) – The Pirate Group

2017 ◽  
Vol 31 (4) ◽  
pp. 57-67
Author(s):  
Marta Pawlak ◽  
Beata Wnuk ◽  
Daniela Kowalicka ◽  
Aleksandra Rosłoniec
Keyword(s):  
Cerebral Palsy ◽  
Upper Limb ◽  
Movement Therapy ◽  
Limb Function ◽  
Upper Limb Function ◽  
Constraint Induced Movement Therapy ◽  
Significant Difference ◽  
Children With Cerebral Palsy ◽  
Bimanual Training ◽  
Spastic Hemiplegia

Abstract Introduction: Children with cerebral palsy (CP) in the form of spastic hemiplegia experience numerous difficulties concerning an affected upper limb such as reaching for objects, gripping or manipulating them. These limitations affect their everyday activity. Conducting an effective and simultaneously an interesting therapy aimed at meeting the child’s individual needs and improving upper limb function is a challenge for a physiotherapist. The aim of the study was to assess the effectiveness of upper limb therapy carried out within the project titled “The Pirate Group” based on Constraint-Induced Movement Therapy (CIMT) and Bimanual Training (BIT) conducted in a specially arranged environment. Material and methods: The research included 16 children with CP in the form of spastic hemiplegia. Mean age of the study participants was 4.23 years. The children underwent a two-week Constraint-Induced Movement Therapy (CIMT) combined with Bimanual Training (BIT). In order to evaluate the effects of the therapy, each child underwent the Assisting Hand Assessment (AHA) prior to the therapy and after its completion. Results: Statistical analysis revealed a significant difference (p<0.05) between the results of AHA prior to and after the therapy (t(14)=9.12, p<0.0001). An improvement in the affected upper limb function was noted in all the children participating in the research. Conclusions: The project titled “The Pirate Group”, based on CIMT and BIT is an effective therapeutic intervention which improves spontaneous activity of the affected upper limb in children with hemiplegia.

Bimanual Training and Constraint-Induced Movement Therapy in Children With Hemiplegic Cerebral Palsy

2011 ◽  
Vol 25 (8) ◽  
pp. 692-702 ◽  
Author(s):  
Andrew M. Gordon ◽  
Ya-Ching Hung ◽  
Marina Brandao ◽  
Claudio L. Ferre ◽  
Hsing-Ching Kuo ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Movement Therapy ◽  
Constraint Induced Movement Therapy ◽  
Hemiplegic Cerebral Palsy ◽  
Bimanual Training
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