Two hands are better than one: bimanual skill development in children with hemiplegic cerebral palsy

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

“…While most children with spastic unilateral cerebral palsy achieve independent walking and have the intellectual capacity to attend regular schools, about half of these children experience limitations in activities of daily living and restrictions in participation in education, leisure and occupational activities owing to impaired hand and arm function. 1–3…”

“…While most children with spastic unilateral cerebral palsy achieve independent walking and have the intellectual capacity to attend regular schools, about half of these children experience limitations in activities of daily living and restrictions in participation in education, leisure and occupational activities owing to impaired hand and arm function. [1][2][3] This is particularly true for activities that require the use of the two hands to perform more complicated bimanual tasks. 1,4 To meet the task demands, many children choose to forego challenging activities and/or adapt their behaviour at a young age.…”

“…[1][2][3] This is particularly true for activities that require the use of the two hands to perform more complicated bimanual tasks. 1,4 To meet the task demands, many children choose to forego challenging activities and/or adapt their behaviour at a young age. [5][6][7][8][9] As a consequence, these children do not use the affected hand and arm to its full capacity, even when the limb is only mildly impaired.…”

Feasibility of Using Joystick-Operated Ride-on-Toys to Promote Upper Extremity Function in Children With Cerebral Palsy: A Pilot Study

“…5,8,[10][11][12] These long-standing impairments on the affected side may lead to overreliance on the relatively unaffected arm for daily function, which ultimately contributes to developmental disuse of the affected arm. 6,10,12,13 In addition to these sensorimotor impairments, children with HCP demonstrate motor planning deficits. 10 Motor planning involves gathering relevant information about the environment from the sensory systems of the body and using this information to plan, organize, and execute desired motor tasks.…”

Unimanual and Bimanual Intensive Training in Children With Hemiplegic Cerebral Palsy and Persistence in Time of Hand Function Improvement

“…According to Gordon, ''two hands are better than one'' 18 and bimanual training is the best approach to make the children not disregard the affected limb. However, in a small sample study, Sutcliffe reported that all children presenting developmental disregard showed increased hand use after constraintinduced movement therapy treatment, documented using the Pediatric Motor Activity Log (P-MAL) and Assisting Hand Assessment (AHA).…”