Article

Constraint-induced movement therapy (CIMT) promotes hand function
using intensive unimanual practice along with restraint of the less-affected
hand. CIMT has not been compared with a treatment with equivalent dosing
frequency and intensity in children with cerebral palsy (CP). OBJECTIVES: The
authors report a randomized trial comparing CIMT and a bimanual intervention
(hand-arm intensive bimanual therapy; HABIT) that maintains the intensity of
practice associated with CIMT but where children are engaged in functional
bimanual tasks. METHODS: A total of 42 participants with hemiplegic CP between
the ages of 3.5 and 10 years (matched for age and hand function) were randomized
to receive 90 hours of CIMT or an equivalent dosage of functional bimanual
training (HABIT) conducted in day-camp environments. A physical therapist blinded
to treatment allocation tested hand function before and after treatment. The
primary outcomes were changes in Jebsen-Taylor Test of Hand Function (JTTHF) and
Assisting Hand Assessment (AHA) scores. Secondary measures included the Goal
Attainment Scale (GAS). RESULTS: Both the CIMT and HABIT groups demonstrated
comparable improvement from the pretest to immediate posttest in the JTTHF and
AHA (P < .0001), which were maintained at 6 months. GAS, however, revealed
greater progress toward goals for the HABIT group (P < .0001), with continued
improvement across test sessions for both groups (P < .0001). CONCLUSIONS: Both
CIMT and bimanual training lead to similar improvements in hand function. A
potential benefit of bimanual training is that participants may improve more on
self-determined goals.

Langue : ANGLAIS