ORIGINAL PAPER
Effectiveness of routine physical therapy with or without home-based intensive bimanual training on clinical outcomes in cerebral palsy children: a randomised controlled trial
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Department of Physical Therapy, TIMES Institute, Multan, University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan
 
 
Submission date: 2022-03-25
 
 
Acceptance date: 2022-10-27
 
 
Publication date: 2024-03-25
 
 
Physiother Quart. 2024;32(1):78-83
 
KEYWORDS
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ABSTRACT
Introduction:
This study aimed to test how normal physical treatment, with or without home-based intense bimanual training, affected hand coordination and daily living activities in children with cerebral palsy.

Methods:
A randomised controlled experiment was carried out at DHQ Hospital in Kasur, Pakistan. Thirty children with unilateral spastic cerebral palsy took part in the study. The first group received standard physical treatment, whereas the second group received bimanual training along with routine physical therapy. Follow-ups were performed in the fourth and sixth weeks. The paediatric motor log activity scale and the ABILHAND questionnaire were used to assess daily activities and coordination, respectively.

Results:
At baseline, no significant association was seen between treatment groups and hand coordination outcome among the patients (p = 0.0450) and no significant difference was seen in patients in both treatment groups regarding their activities of daily living. In group A, no significant improvement was seen in hand coordination from baseline until the 6th week (p = 0.257) while in group B, a significant difference was seen in hand coordination from baseline until the 6th week follow-up (p = 0.000).

Conclusions:
This study concluded that the combined effect of home-based bimanual exercises and routine physical therapy shows significant achievements in hand coordination and activities of daily living.

 
REFERENCES (31)
1.
Patel DR, Neelakantan M, Pandher K, Merrick J. Cerebral palsy in children: a clinical overview. Translational pediatrics. 2020;9(Suppl 1):125:125–135; doi: 10.21037/tp.2020.01.01.
 
2.
Hurley DS, Sukal-Moulton T, Msall ME, Gaebler-Spira D, Krosschell KJ, Dewald JP. The cerebral palsy research registry. development and progress toward national collaboration in the United States. J Child Neurol. 2011;26(12):1534–154; doi: 10.1177/0883073811408903.
 
3.
Ahmad A, Akhtar N, Hjkkmuj A. Prevalence of cerebral palsy in children of district swabi. Khyber Pakhtunkhwa-Pakistan.Khyber Medical University Journal, 2017;9(2);.
 
4.
Sellier E, Platt MJ, Andersen GL, Krägeloh-Mann I, De La Cruz J, Cans C, et al. Decreasing prevalence in cerebral palsy. a multi-site European population-based study, 1980 to 2003. Dev Med Child Neurol. 2016;58(1): 85–92; https://doi.org/10.1111/dmcn.1....
 
5.
Ferre CL, Brandão M, Surana B, Dew AP, Moreau NG, Gordon AM. Caregiver-directed home-based intensive bimanual training in young children with unilateral spastic cerebral palsy: a randomized trial. Dev Med Child Neurol. 2017;59(5):497–504; doi: 10.1111/dmcn.13330.
 
6.
Uswatte G, Taub E, Griffin A, Vogtle L, Rowe J, Barman J. The pediatric motor activity log-revised: assessing real-world arm use in children with cerebral palsy. Rehabil Psychol. 2012;57(2):149; doi: 10.1037/a0028516.
 
7.
Bleyenheuft Y, Gordon AM, Rameckers E, Thonnard JL, Arnould CJDM, Neurology C. Measuring changes of manual ability with ABILHAND-Kids following intensive training for children with unilateral cerebral palsy. Dev Med Child Neurol. 2017;59(5):505–511; doi: 10.1111/dmcn.13338.
 
8.
Barisic A, Leatherdale ST, Kreiger N. Importance of frequency, intensity, time and type (FITT) in physical activity assessment for epidemiological research. Can J Public Health. 2011;102(3):174–175; doi: 10.1007/BF03404889.
 
9.
Bleyenheuft Y, Ebner-Karestinos D, Surana B, Paradis J, Sidiropoulos A, Renders A, et al. Intensive upper- and lower-extremity training for children with bilateral cerebral palsy: a quasi-randomized trial. Dev Med Child Neurol. 2017;59(6):625–633; doi: 10.1111/dmcn.13379.
 
10.
Gordon AMJDM, Neurology C. To constrain or not to constrain, and other stories of intensive upper extremity training for children with unilateral cerebral palsy. Dev Med Child Neurol.2011;53: 56-61; doi: 10.1111/j.1469-8749.2011.04066.x.
 
11.
Aaron C, Chiarello LA, Palisano RJ, Gracely E, O’Neil M, Kolobe TJP, et al. Relationships among family participation, team support, and intensity of early intervention services. Phys Occup Ther Pediatr. 2014;34(4):343–355; doi:10.3109/01942638.2014.899286.
 
12.
Gelkop N, Burshtein DG, Lahav A, Brezner A, Al-Oraibi S, Ferre CL, et al. Efficacy of constraint-induced movement therapy and bimanual training in children with hemiplegic cerebral palsy in an educational setting. Phys Occup Ther Pediatr. 2015;35(1):24-39; doi: 10.3109/01942638.2014.925027.
 
13.
Ferre CL, Brandão MB, Hung Y-C, Carmel JB, Gordon AM. Feasibility of caregiver-directed home-based hand-arm bimanual intensive training: a brief report. Dev Neurorehabil. 2015;18(1):69–74; doi: 10.3109/17518423.2014.948641.
 
14.
Wallen M, Ziviani J, Naylor O, Evans R, Novak I, Herbert RD. Modified constraint-induced therapy for children with hemiplegic cerebral palsy: a randomized trial. Dev Med Child Neurol. 2011;53(12):1091–1099; doi: j.1469-8749.2011.04086.x.
 
15.
Novak I, Cusick A, Lannin NJP. Occupational therapy home programs for cerebral palsy: a double-blind, randomized, controlled trial. Pediatrics. 2009;124(4): 606–614; doi: 10.1542/peds.2009-0288.
 
16.
Sakzewski L, Miller L, Ziviani J, Abbott DF, Rose S, Macdonell RA, et al. Randomized comparison trial of density and context of upper limb intensive group versus individualized occupational therapy for children with unilateral cerebral palsy.  Dev Med Child Neurol.2015; 57(6): 539–547; doi: 10.1111/dmcn.12702.
 
17.
Bleyenheuft Y, Arnould C, Brandao MB, Bleyenheuft C, Gordon AMJN, repair n. Hand and arm bimanual intensive therapy including lower extremity (HABIT-ILE) in children with unilateral spastic cerebral palsy: a randomized trial. Neurorehabil Neural Repair. 2015; 29(7):645–657; doi: 10.1177/1545968314562109.
 
18.
Dong VA-Q, Tung IH-H, Siu HW-Y, Fong K N-K. Studies comparing the efficacy of constraint-induced movement therapy and bimanual training in children with unilateral cerebral palsy: a systematic review. Dev Neurorehabil. 2013;16(2):133–143; oi: 10.3109/17518423.2012.702136.
 
19.
Gordon AM, Hung Y-C, Brandao M, Ferre CL, Kuo H-C, Friel K, et al. Bimanual training and constraint-induced movement therapy in children with hemiplegic cerebral palsy: a randomized trial. Neurorehabil Neural Repair. 2011;25(8):692–702; doi: org/10.1177/1545968311402508.
 
20.
de Brito Brandao M, Gordon AM, Mancini MC. Functional impact of constraint therapy and bimanual training in children with cerebral palsy: a randomized controlled trial. Neurorehabil Neural Repair. 2012;25(8): 692–702; doi: 10.5014/ajot.2012.004622.
 
21.
Sakzewski L, Ziviani J, Abbott DF, Macdonell RA, Jackson GD, Boyd RN. Equivalent retention of gains at 1 year after training with constraint-induced or bimanual therapy in children with unilateral cerebral palsy. Neurorehabil Neural Repair. 2011;25(7):664–671; doi: org/10.1177/1545968311400093.
 
22.
Fedrizzi E, Rosa-Rizzotto M, Turconi AC, Pagliano E, Fazzi E, Pozza LVD, et al. Unimanual and bimanual intensive training in children with hemiplegic cerebral palsy and persistence in time of hand function improvement: 6-month follow-up results of a multisite clinical trial. J Child Neurol. 2013;28(2):161–175; doi: org/10.1177/0883073812443004.
 
23.
Maher CA, Williams MT, Olds TSJIJoRR. The six-minute walk test for children with cerebral palsy. International J Rehabil Res. 2008;31(2):185–188; doi: 10.1097/MRR.0b013e32830150f9.
 
24.
Novak I, Mcintyre S, Morgan C, Campbell L, Dark L, Mor­ton N, et al. A systematic review of interventions for children with cerebral palsy: state of the evidence. Dev Med Child Neurol.  2013;55(10):885–910; doi: 10.1111/dmcn.12246.
 
25.
Charles J, Gordon AMJDM, Neurology C. Development of hand-arm bimanual intensive training (HABIT) for improving bimanual coordination in children with hemiplegic cerebral palsy. Dev Med Child Neurol. 2006;48(11):931–936; doi: 10.1017/S0012162206002039.
 
26.
Nudo R. Adaptive plasticity in motor cortex: implications for rehabilitation after brain injury. J Rehabil Med Suppl. 2003;41:7–10; doi: 10.1017/S0012162206002039.
 
27.
Badaru UM, Ogwumike OO, Adeniyi AF. Effect of task-oriented exercise training program on the functional performance of children with cerebral palsy. Physiother Quart. 2021;28(1):40–48; doi: 10.5114/pq.2020.100293.
 
28.
Ismaeel M. Contralateral effect of unilateral motor priming on grasping in children with unilateral spastic cerebral palsy. Physiother Quart. 2022;30(1):46–50; doi: 10.5114/pq.2020.102166.
 
29.
Remón ÁL, Panufnik MA. Effectiveness of therapeutic suits and intensive suit trainings in individuals with cerebral palsy and other neurological disorders: a scoping review. Physiother Quart. 2021;29(2):12–22; doi: 10.5114/pq.2020.100276.
 
30.
Eliasson AC, Shaw K, Berg E, Krumlinde-Sundholm L. An ecological approach of Constraint Induced Movement Therapy for 2–3-year-old children: a randomized control trial. Res Dev Disabil. 2011;32(6):2820–2828; doi: 10.1016/j.ridd.2011.05.024.
 
31.
Gelkop N, Burshtein DG, Lahav A, Brezner A, Al-Oraibi S, Ferre CL, Gordon AM. Efficacy of constraint-induced movement therapy and bimanual training in children with hemiplegic cerebral palsy in an educational setting. Phys Occup Ther Pediatrics. 2015; 35(1):24–39; doi: 10.3109/01942638.2014.925027.
 
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