Article

The aim of this study was to determine whether constraint-induced movement
therapy is more effective than bimanual training in improving the quality of life
of children with unilateral cerebral palsy (CP). Method Sixty-three children
(mean age 10y 2mo [SD 2y 6mo]; 33 males, 30 females)
with CP of the spastic motor
type (n=59) or with spasticity and dystonia (n=4) were randomly allocated to two
groups. The children were assessed as Manual Ability Classification System level
I (n=16), II (n=46), or III (n=1). Each group received 6 hours of daily
intervention (either constraint-induced movement therapy [CIMT] or bimanual
training [BIM]) for 10 days over a 2-week period (total intervention time 60h).
Children aged 9 years and older completed the Cerebral Palsy Quality of Life
Questionnaire for Children (CPQOL-Child) and those aged 8 years and older
completed the KIDSCREEN-52. All parents completed proxy versions of each measure.
Assessments were made at baseline and at 3, 26, and 52 weeks after the end of the
intervention. Results : Thirty-five children completed the CPQOL-Child and 41
completed the KIDSCREEN-52. No changes in social or emotional well-being were
reported by children in either group. Children and parents from both groups
reported a significant improvement in their or their child's feelings about
functioning as well as participation and physical health on the CPQOL-Child. The
parents of children receiving CIMT reported positive and sustained changes in
their child's social well-being (CPQOL-Child). The CIMT group showed significant
improvements in physical well-being, psychological well-being, and moods and
emotions (KIDSCREEN-52) at 3 weeks post intervention, which were maintained over
the study period. Interpretation Intensive goal-directed upper limb training
programmes using either CIMT or BIM achieved domain-specific changes in quality
of life relating to feelings about functioning and participation and physical health. A condition-specific quality of life compared with a generic measure may
be better able to detect changes in quality of life in children with unilateral CP.
CI - (c) The Authors. Developmental Medicine & Child Neurology (c) 2012 Mac Keith
Press.

Langue : ANGLAIS