Article

AIM: To determine whether short-term intensive group-based therapy combining
modified constraint-induced movement therapy and bimanual therapy (hybrid-CIMT)
is more effective than an equal total dose of distributed individualized
occupational therapy (standard care) on upper limb motor and individualized
outcomes. METHOD: Fifty-three children with unilateral cerebral palsy (69% males;
mean age 7y 10mo, SD 2y 4mo; Manual Ability Classification System level I, n=24;
level II, n=23) were randomly allocated, and 44 received either hybrid-CIMT
(n=25) or standard care (n=19). Standard care comprised six weekly occupational
therapy sessions and a 12-week home programme. Outcomes were assessed at
baseline, 13 weeks, and 26 weeks after treatment. RESULTS: Groups were equivalent
at baseline. Standard care achieved greater gains on satisfaction with
occupational performance after intervention (estimated mean difference -1.2, 95%
CI -2.2 to -0.1; p=0.04) and Assisting Hand Assessment at 26 weeks (estimated
mean difference 3.1, 95% CI 0.2-6.0; p=0.04). Both groups demonstrated
significant improvements in dexterity of the impaired upper limb, and bimanual
and occupational performance over time. The differences between groups were not
clinically meaningful. INTERPRETATION: There were no differences between the two
models of therapy delivery. Group-based intensive camps may not be readily
available; however, individualized standard care augmented with a home programme
may offer an effective alternative but needs to be provided at a sufficient dose.
CI - (c) 2015 Mac Keith Press.

Langue : ANGLAIS