European Journal of Biomedical and Pharmaceutical Sciences

BIMANUAL TRAINING THERAPY VERSUS CONSTRAINED INDUCED MOVEMENT THERAPY ON UPPER LIMB FUNCTION IN CHILDREN WITH HEMIPLEGIC CEREBRAL PALSY

Abdel Aziz A. Sherief*

ABSTRACT

Background and purpose: Children with hemiplegic cerebral palsy have impairments in upper limb function beyond their unilateral impairments. The current study was conducted to compare the effect of bimanual training therapy versus constrained induced movement therapy (CIMT) on the affected upper extremity in children with hemiplegic cerebral palsy. Materials and methods: Thirty hemiplegic children ranged in age from 8 to 10 years with hand spasticity ranged between 1 and 1+ grades according to the Modified Ashworth Scale participated in this study. They were assigned randomly into two equal study groups. Group A received a designed physical therapy program and constrained induced movement therapy, while the group B received the same physical therapy program in addition to play and functional activities that provided structured bimanual practice 1 h per day for bimanual intensive therapy. Both groups received treatment sessions three times per week for three successive moths .Each child in the two groups was evaluated before and after the suggested treatment duration for detecting the level of hand performance using the Peabody Developmental Test of Motor Proficiency while, hand grip strength by a hand held dynamometer and active abduction and external rotation range of motion were measured by a standard universal goniometer. Results: The results revealed non significant differences when comparing the pre-treatment mean values of all measuring variables for the two groups (p< 0.05), while significant improvement was observed in the two groups when comparing their pre and post treatment mean values. Also, significant differences were observed when comparing the post treatment results of the two groups in favor of the group B (p< 0.05). Conclusion: The results suggested that, hand-arm bimanual intensive therapy appears to have appositive impact on hand function in children with hemiplegic cerebral palsy.

Keywords: Cerebral palsy; Hemiplegic; bimanual intensive therapy constrained induced movement therapy.