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Introduction: Cerebral Palsy (CP) patients who have spastic hemiparesis usually present asymmetrical weight shift between the affected and non-affected side. Objective: To assess the effects of upper limb (UL) weight-bearing exercises on trunk symmetry, weight shift to the affected side and possible secondary effects on gait (speed and quality). Method: eleven participants with CP were randomized into two groups: Intervention Group (IG) and Control Group (CG); IG (n = 6) performed stretching exercises of the major muscle groups of UL and lower limbs (LL) and UL weight-bearing exercises in prone and seated position for 12 weeks. The CG (n = 5) did not undergo any kind of motor therapy during the study period but received the same exercises that IG after the study. The variables analyzed were: Gross Motor Function Measure (GMFM-88); Pediatric Berg Scale; Trunk Impairment Scale (TIS); Six-minute walking test (6MWT); Ten meters walking test (10MWT); Timed Up & Go (TUG); Edinburgh Visual Gait Scale (EVGS); and ground reaction force. Results: The IG showed improvement on 6MWT, TUG, TIS and Pediatric Berg Scale (p < 0.01), and CG showed improvement on GMFM-88 (p < 0.04) only for the intragroup analysis. Conclusion: The exercises were effective to improve static and dynamic balance, increasing gait speed and identifying a trend of improvement on body alignment and weight shift to the affected side.

Objective To determine if the original protocol of Constraint-Induced Movement Therapy (CIMT), is adequate to reverse the nonuse of the affected upper limb (AUL) in patients with Cerebral Palsy (CP) in adulthood. Method The study included 10 patients diagnosed with CP hemiparesis had attended the adult protocol CIMT, from January/August 2009/2014. Results Average age 24.6 (SD 9.44); MAL average pretreatment How Often (HO) = 0.72 and How Well (HW) = 0.68 and post-treatment HO = 3.77 and HW = 3.60 (p ≤ 0.001) and pretreatment WMFT average = 21.03 and post-treatment average = 18.91 (p = 0.350). Conclusion The constraint-induced movement therapy is effective to reverse the nonuse learn of the AUL in adult patients with CP.

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Introdução: Terapia por Contensão Induzida (TCI) visa o aprendizado motor para reversão do desuso aprendido em pacientes com hemiparesia espástica. Objetivo: Verificar a efetividade do protocolo modificado da TCI pediátrica quanto ao aumento da função do membro superior (MS) afetado em pacientes com Paralisia Cerebral (PC) hemiparéticos espásticos. Métodos: O protocolo modificado foi aplicado em 23 pacientes (crianças e adolescentes) no período de três semanas, duas horas diárias de treino intensivo e uso do gesso 24 horas por dia no MS não afetado. Durante o tratamento foram aplicadas as escalas Pediatric Motor Activity Log (PMAL) ou Tween Motor Activity Log (TMAL), Pediatric Arm Functional Test (PAFT) e Inventory New Motor and Programs (INMAP). Resultados: Pós-tratamento houve melhora da frequência (p < 0,001) e qualidade (p < 0,001) dos movimentos nas escalas PMAL/TMAL. Adolescentes apresentaram melhores resultados na frequência (p = 0,011). A melhora se iniciou no 3° e 4° dia, atingindo platô entre o 11° e 12°. Aumento da pontuação do uso espontâneo nas tarefas unilaterais e bilaterais da escala PAFT. Aquisição de novos programas motores do INMAP (p = 0,027). Houve correlação fraca e não significante entre a escala de habilidade funcional da PAFT e a variável qualidade da PMAL. Conclusão: A TCI mostrou-se efetiva quanto ao aumento da função do MS afetado em pacientes com PC.Palavras-chave: paralisia cerebral, hemiparesia, reabilitação, extremidade superior.