Intensive Upper Extremity Training for Children with Hemiplegia: From Science to Practice

For children with hemiplegic cerebral palsy, bimanual abilities are central to independent function. Over the last decade, considerable attention has been given to 2 forms of extended practice therapy for the upper limb, constraint-induced movement therapy and intensive bimanual training. This artic...

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Bibliographic Details
Published in:Seminars in pediatric neurology 2013-06, Vol.20 (2), p.100-105
Main Authors: Andersen, John C., MD, Majnemer, Annette, OT, PhD, O'Grady, Kathleen, OT, Gordon, Andrew M., PhD
Format: Article
Language:English
Subjects:
Cerebral Palsy - complications
Cerebral Palsy - physiopathology
Cerebral Palsy - rehabilitation
Exercise Therapy - methods
Hemiplegia - complications
Hemiplegia - physiopathology
Hemiplegia - rehabilitation
Humans
Neurology
Pediatrics
Upper Extremity - physiology
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Summary:For children with hemiplegic cerebral palsy, bimanual abilities are central to independent function. Over the last decade, considerable attention has been given to 2 forms of extended practice therapy for the upper limb, constraint-induced movement therapy and intensive bimanual training. This article reviews the varying nature of these 2 approaches and the existing scientific rationale supporting them. Comparisons between these 2 intensive upper extremity training approaches indicate similar improvements in unimanual capacity and bimanual performance outcomes; however, when considering participant and caregiver goal achievement, evidence favors a bimanual approach. Careful selection of either therapy for this population requires consideration of individual and contextual factors in relation to treatment goals. The key ingredients and dose responses remain unknown. Treatment intensity, intrinsic motivation, and individualization of treatment are hypothesized as requisite in either approach.
ISSN:1071-9091
1558-0776
DOI:10.1016/j.spen.2013.06.001