BACKGROUND:Constraint-induced movement therapy (CIMT) promotes hand function using intensive unimanual practice along with restraint of the less-affected hand. CIMT has not been compared with a treatment with equivalent dosing frequency and intensity in children with cerebral palsy (CP). OBJECTIVES: The authors report a randomized trial comparing CIMT and a bimanual intervention (hand-arm intensive bimanual therapy; HABIT) that maintains the intensity of practice associated with CIMT but where children are engaged in functional bimanual tasks. METHODS: A total of 42 participants with hemiplegic CP between the ages of 3.5 and 10 years (matched for age and hand function) were randomized to receive 90 hours of CIMT or an equivalent dosage of functional bimanual training (HABIT) conducted in day-camp environments. A physical therapist blinded to treatment allocation tested hand function before and after treatment. The primary outcomes were changes in Jebsen-Taylor Test of Hand Function (JTTHF) and Assisting Hand Assessment (AHA) scores. Secondary measures included the Goal Attainment Scale (GAS). RESULTS: Both the CIMT and HABIT groups demonstrated comparable improvement from the pretest to immediate posttest in the JTTHF and AHA (P < .0001), which were maintained at 6 months. GAS, however, revealed greater progress toward goals for the HABIT group (P < .0001), with continued improvement across test sessions for both groups (P < .0001). CONCLUSIONS: Both CIMT and bimanual training lead to similar improvements in hand function. A potential benefit of bimanual training is that participants may improve more on self-determined goals.
RCT Entities:
BACKGROUND: Constraint-induced movement therapy (CIMT) promotes hand function using intensive unimanual practice along with restraint of the less-affected hand. CIMT has not been compared with a treatment with equivalent dosing frequency and intensity in children with cerebral palsy (CP). OBJECTIVES: The authors report a randomized trial comparing CIMT and a bimanual intervention (hand-arm intensive bimanual therapy; HABIT) that maintains the intensity of practice associated with CIMT but where children are engaged in functional bimanual tasks. METHODS: A total of 42 participants with hemiplegic CP between the ages of 3.5 and 10 years (matched for age and hand function) were randomized to receive 90 hours of CIMT or an equivalent dosage of functional bimanual training (HABIT) conducted in day-camp environments. A physical therapist blinded to treatment allocation tested hand function before and after treatment. The primary outcomes were changes in Jebsen-Taylor Test of Hand Function (JTTHF) and Assisting Hand Assessment (AHA) scores. Secondary measures included the Goal Attainment Scale (GAS). RESULTS: Both the CIMT and HABIT groups demonstrated comparable improvement from the pretest to immediate posttest in the JTTHF and AHA (P < .0001), which were maintained at 6 months. GAS, however, revealed greater progress toward goals for the HABIT group (P < .0001), with continued improvement across test sessions for both groups (P < .0001). CONCLUSIONS: Both CIMT and bimanual training lead to similar improvements in hand function. A potential benefit of bimanual training is that participants may improve more on self-determined goals.
Authors: Michele A Lobo; John Koshy; Martha L Hall; Ozan Erol; Huantian Cao; Jenner M Buckley; James C Galloway; Jill Higginson Journal: Phys Ther Date: 2015-08-27
Authors: Claudio L Ferre; Jason B Carmel; Véronique H Flamand; Andrew M Gordon; Kathleen M Friel Journal: Neurorehabil Neural Repair Date: 2020-01-26 Impact factor: 3.919
Authors: Nathalie L Maitre; Gena Henderson; Shirley Gogliotti; Jennifer Pearson; Ashley Simmons; Lu Wang; James C Slaughter; Alexandra P Key Journal: J Clin Exp Neuropsychol Date: 2014-06-23 Impact factor: 2.475
Authors: Ana R P Smorenburg; Andrew M Gordon; Hsing-Ching Kuo; Claudio L Ferre; Marina Brandao; Yannick Bleyenheuft; Jason B Carmel; Kathleen M Friel Journal: Neurorehabil Neural Repair Date: 2016-11-17 Impact factor: 3.919