Effectiveness of Combination of Constraint Induced Movement Therapy with Bimanual Intensive Therapy on Fine Motor Skills in Children with Hemiplegic Cerebral Palsy

The aim of this study was to investigate the effectiveness of combination of constraint induced movement therapy and bimanual intensive therapy on fine motor skills of children with hemiplegic cerebral palsy.

In this RCT study, 25 children with hemiplegic cerebral palsy aged 60-120 months participated they were assigned randomly into intervention and control groups. The children in control group received current occupational therapy intervention and children in intervention group were received a combination of constraint induced movement therapy and bimanual intensive therapy in addition to current occupational therapy. Each session was started with restraint on non-involved upper extremity and practicing with the involved upper extremity for three hours and followed by bimanual intensive therapy for another three hours. This process lasted for 10 out of 12 consecutive days. Fine motor skills and muscle tone were assessed by Bruininks-Oseretsky test and modified Ashworth scale, respectively.

Fine motor skills of these children in intervention group improved significantly (P<0/05), however the level of spasticity was not significantly different between these two groups (P>0/05).

The findings suggest that combination of constraint induced movement therapy and bimanual intensive therapy could improve fine motor skills in the hemiplegic cerebral palsy children.