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Intensive Unimanual Training Leads to Better Reaching and Head Control than Bimanual Training in Children with Unilateral Cerebral Palsy.

PUBLICATION: 
Journal Article
Authors: 
Hung YC, Spingarn A, Friel KM, Gordon AM.
Year Published: 
2020
Publisher: 
Phys Occup Ther Pediatr. 2020;40(5):491-505. doi: 10.1080/01942638.2020.1712513. Epub 2020 Jan 16.
Identifiers: 
PMID: 31942818 | DOI: 10.1080/01942638.2020.1712513
Abstract on PubMed

Abstract

Aims

To quantify the changes in joint movement control and motor planning of the more-affected upper extremity (UE) during a reach-grasp-eat task in children with Unilateral Spastic Cerebral Palsy (USCP) after either constraint-induced movement therapy (CIMT) or hand-arm bimanual intensive therapy (HABIT).

Methods

Twenty children with USCP (average age 7.7; MACS levels I-II) were randomized into either a CIMT or HABIT group. Both groups received intensive training 6 h a day for 15 days. Children performed a reach-grasp-eat task before and after training with their more-affected hand using 3D kinematic analysis.

Results

Both groups illustrated shorter movement time during reaching, grasping, and eating phases after training (p < 0.05). Additionally, both intensive training approaches improved joint control with decreased trunk involvement, greater elbow, and wrist excursions during the reaching phase, and greater elbow excursion during the eating phase (p < 0.05). However, only the CIMT group decreased hand curvature during reaching, lowered hand position at grasp, and decreased head rotation during the eating phase (p < 0.05).

Conclusions

The current findings showed that both CIMT and HABIT improved UE joint control, but there were greater effects of CIMT on the more-affected UE motor planning and head control for children with USCP.

Associated

Conditions & Recovery

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