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

Tervahauta, MH; Girolami, GL; Øberg, G.K.

doi:10.1177/0269215517698834

Cited by 30 publications

(18 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…CIMT for children with CP, was the only intervention comprehensively and empirically compared to other intervention options, using head‐to‐head RCT comparisons identified in our search strategy. CIMT was: (i) compared head‐to‐head with Bimanual Training showing no difference between the approaches (Sakzewski et al ., ; Tervahauta, Girolami & Øberg, ); and (ii) combined with Bimanual Training and/or Botulinum toxin A, showing no additive benefits occurred from a combined intervention approach (Hoare et al ., ). These researcher's concluded ‘intensity’ of practice was the key ingredient of these effective CP approaches (Sakzewski et al .; Tervahauta et al ., ).…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of paediatric occupational therapy for children with disabilities: A systematic review

Novak

Honan²

2019

Aus Occup Therapy J

190

120

View full text Add to dashboard Cite

IntroductionPaediatric occupational therapy seeks to improve children's engagement and participation in life roles. A wide variety of intervention approaches exist. Our aim was to summarise the best‐available intervention evidence for children with disabilities, to assist families and therapists choose effective care.MethodsWe conducted a systematic review (SR) using the Cochrane methodology, and reported findings according to PRISMA. CINAHL, Cochrane Library, MEDLINE, OTSeeker, PEDro, PsycINFO were searched. Two independent reviewers: (i) determined whether studies met inclusion: SR or randomised controlled trial (RCT); an occupational therapy intervention for children with a disability; (ii) categorised interventions based on name, core components and diagnostic population; (iii) rated quality of evidence and determined the strength of recommendation using GRADE criteria; and (iv) made recommendations using the Evidence Alert Traffic Light System.Results129 articles met inclusion (n = 75 (58%) SRs; n = 54 (42%)) RCTs, measuring the effectiveness of 52 interventions, across 22 diagnoses, enabling analysis of 135 intervention indications. Thirty percent of the indications assessed (n = 40/135) were graded ‘do it’ (Green Go); 56% (75/135) ‘probably do it’ (Yellow Measure); 10% (n = 14/135) ‘probably don't do it’ (Yellow Measure); and 4% (n = 6/135) ‘don't do it’ (Red Stop). Green lights were: Behavioural Interventions; Bimanual; Coaching; Cognitive Cog‐Fun & CAPS; CO‐OP; CIMT; CIMT plus Bimanual; Context‐Focused; Ditto; Early Intervention (ABA, Developmental Care); Family Centred Care; Feeding interventions; Goal Directed Training; Handwriting Task‐Specific Practice; Home Programs; Joint Attention; Mental Health Interventions; occupational therapy after toxin; Kinesiotape; Pain Management; Parent Education; PECS; Positioning; Pressure Care; Social Skills Training; Treadmill Training and Weight Loss ‘Mighty Moves’.ConclusionEvidence supports 40 intervention indications, with the greatest number at the activities‐level of the International Classification of Function. Yellow light interventions should be accompanied by a sensitive outcome measure to monitor progress and red light interventions could be discontinued because effective alternatives existed.

show abstract

Section: Resultsmentioning

confidence: 99%

Effectiveness of paediatric occupational therapy for children with disabilities: A systematic review

Novak

Honan²

2019

Aus Occup Therapy J

190

120

View full text Add to dashboard Cite

show abstract

“…However, in the Hybrid-CIMT programme, strength needs to be sufficient in order to be able to grasp and hold in the first part of the programme where CIMT is performed, and the hand is trained unimanually. 45 The dosage of mCIMT and BIT differs among the articles found in the literature 33 , 44 – 48 ; evidence shows that BIT and mCIMT have similar effects when the same dose is compared in children with moderate bimanual functional performance. 33 , 48 , 49 In the study of Deppe et al , applied in children with unilateral cerebral palsy or other non-progressive hemiplegia (aged 3.3–11.4 years), 45 two intensive protocols were performed with a total dose of 80 h: hybrid-CIMT protocol comprised of 60 h of CIMT and 20 h of BIT in a clinical setting.…”

Section: Introductionmentioning

confidence: 99%

“… 45 The dosage of mCIMT and BIT differs among the articles found in the literature 33 , 44 – 48 ; evidence shows that BIT and mCIMT have similar effects when the same dose is compared in children with moderate bimanual functional performance. 33 , 48 , 49 In the study of Deppe et al , applied in children with unilateral cerebral palsy or other non-progressive hemiplegia (aged 3.3–11.4 years), 45 two intensive protocols were performed with a total dose of 80 h: hybrid-CIMT protocol comprised of 60 h of CIMT and 20 h of BIT in a clinical setting. The results of this study suggested higher treatment gains for more severely impaired children with hybrid-CIMT.…”

Section: Introductionmentioning

confidence: 99%

Combined intensive therapies at home in spastic unilateral cerebral palsy with high bimanual functional performance. What do they offer? A comparative randomised clinical trial

Palomo-Carrión

Lirio-Romero

Ferri-Morales

et al. 2021

Therapeutic Advances in Chronic Disease

View full text Add to dashboard Cite

Background: Children with unilateral spastic cerebral palsy (USCP) receive different treatments, including the application of modified constraint induced movement therapy (mCIMT) or bimanual intensive therapy (BIT) to increase affected upper limb functionality. The aim of this study was to compare the effectiveness of two protocols with different proportions and orders of mCIMT/BIT within combined intensive home-therapy in children with USCP (6–8 years old) with high bimanual functional performance, applied by the family. Methods: The protocols were performed on 20 children with an average age of 7.12 years [standard deviation (SD): 0.70], allocated to two different combined therapies. The protocols were designed by 100 h of dose for 10 weeks: 80 h of mCIMT followed by 20 h of BIT (mCIMT-B group) and 80 h of BIT followed by 20 h of mCIMT (BIT-mCI group). Bimanual functional performance was measured with Assisting Hand Assessment Scale (AHA) and the affected upper limb-use experience with Children’s Hand-use Experience Questionnaire (CHEQ). Parent satisfaction and expectations with therapy were measured using a specific questionnaire. There were five assessment timepoints (week 0, week 4, week 8, week 10 and week 34). Results: There were no statistically significant ( p > 0.05) inter- and intra-group changes in the bimanual functional performance of both groups. The affected upper limb-use experience obtained significant changes in BIT-mCI group, with statistically significant differences in the pairwise comparisons between week 0–10 and week 4–10 ( p = 0.028) for use of the affected hand and the use of the affected hand to grasp between week 4 and week 8 ( p = 0.028). Grasp efficacy and discomfort acquired statistically significant differences only in the BIT-mCI group for pairwise comparisons week 0–week 10/week 4–week 10 ( p = 0.035). Although task execution time compared with a typically developing child of the same age obtained statistically significant differences only in the group mCIMT-B for pairwise comparisons week 0–week 8 ( p = 0.03), week 0–week 10 ( p = 0.03), week 4–week 8 ( p = 0.04) and week 4–week 10 ( p = 0.03). Family satisfaction and expectations acquired an increase between week 0 and week 10 ( p ⩽ 0.02). Conclusion: Applying 80 h of BIT for 8 weeks in children with high bimanual functional performance USCP (6–8 years old), executed at home with family involvement would be sufficient to obtain improvements in affected upper limb-use experience, without the need to use combined protocols of 100 h. However, no statistically significant increase in bimanual functional performance would be obtained, with the basal situation of the child being a factor to consider for the execution of mCIMT and BIT. Registration number and name of trial registry: [ClinicalTrials.gov identifier: NCT03465046]

show abstract

“…To improve manual abilities in the CP population, different approaches include treatments that attempt to reduce hand impairment by increasing hand dexterity and strength (Moon et al, 2017) and others that emphasize hand function with movement constraint or promoting bimanual activities (Tervahauta et al, 2017). According to the International Classification of Functioning Disability and Health, rehabilitation professionals should attend to both body and activity domains.…”

Section: Introductionmentioning

confidence: 99%

Examining Reliability and Validity of the Jebsen-Taylor Hand Function Test Among Children With Cerebral Palsy

et al. 2020

View full text Add to dashboard Cite

Manual dexterity has strongly predicted functional independence for daily life activities among children with cerebral palsy (CP). The Jebsen-Taylor Hand Function Test (JTHFT) is the most widely used assessment tool for exploring manual dexterity in the CP population, though no research has yet examined its psychometric properties for this use. This cross-sectional study explored the validity and internal consistency of the JTHFT in an Italian sample of inpatient and outpatient children with CP aged between 6-18 years (35 girls and 49 boys). We calculated internal consistency with Cronbach’s alpha and tested validity against the Manual Ability Classification System (MACS) using Pearson’s correlation coefficient. To better understand how the JTHFT compares with different levels of the MACS, we performed dominant hand timing variability for each test item. Results showed excellent internal consistency with a Cronbach’s alpha of .944 and .911, respectively, for nondominant and dominant hands. There was also a statistically significant positive linear Pearson’s correlation coefficient between the JTHFT and the MACS ( p < .01). We observed high variability in writing performance (Item 1 of the JTHFT) within this sample for each level of the MACS. This study confirms that the JTHFT is a valid assessment tool when used in children with CP aged 6-18 years.

show abstract

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

Abstract: 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.

Cited by 30 publications

References 50 publications

Effectiveness of paediatric occupational therapy for children with disabilities: A systematic review

Effectiveness of paediatric occupational therapy for children with disabilities: A systematic review

Combined intensive therapies at home in spastic unilateral cerebral palsy with high bimanual functional performance. What do they offer? A comparative randomised clinical trial

Examining Reliability and Validity of the Jebsen-Taylor Hand Function Test Among Children With Cerebral Palsy

Contact Info

Product

Resources

About