Article

In children with unilateral spastic cerebral palsy (CP), there is
only limited evidence for the effectiveness of modified constraint-induced
movement therapy (mCIMT). OBJECTIVE: To investigate whether 6 weeks of mCIMT
followed by 2 weeks of bimanual task-specific training (mCIMT-BiT) in children
with unilateral spastic CP improves the spontaneous use of the affected limb in
both qualitative and quantitative terms more than usual care (UC) of the same
duration. METHODS: Children with unilateral spastic CP with Manual Ability
Classification System (MACS) scores I, II, or III and aged 2.5 to 8 years were
recruited and randomly allocated to either the mCIMT-BiT group (three 3-hour
sessions per week: 6 weeks of mCIMT, followed by 2 weeks of task-specific
training in goal-directed bimanual play and self-care activities) or to 1.5 hours
of more general physical or occupational weekly plus encouragement to use the
affected hand for the UC group. Primary outcome measures were the Assisting Hand
Assessment and the ABILHAND-Kids. Secondary outcomes were the Melbourne
Assessment of Unilateral Upper Limb Function, the Canadian Occupational
Performance Measure, and the Goal Attainment Scale. RESULTS: Twenty-eight
children were allocated to mCIMT-BiT and 24 to UC. Except for the Melbourne, all
primary and secondary outcome measures demonstrated significant improvements in
the mCIMT-BiT group. CONCLUSION: mCIMT followed by task-specific training of
goal-directed bimanual play and self-care activities is an effective intervention
to improve the spontaneous use of the more affected upper limb in children with
relatively good baseline upper extremity function.

Langue : ANGLAIS