Unimanual and bimanual intensive training in children with hemiplegic cerebral palsy and persistence in time of hand function improvement: 6 months follow-up results of a multisite clinical trial

The study aims to compare in hemiplegic children the effectiveness of Intensive Training (Unimanual and Bimanual) vs Standard Treatment in improving hand function, assessing the persistence after 6 months. A multicenter, prospective, cluster-randomized controlled clinical trial was designed comparing 2 groups of children with hemiplegic cerebral palsy, treated for 10-weeks (3 hours/day-7 days/week) (first with unimanual Constraint Induced Movement Therapy, second with Intensive Bimanual Training) with a Standard Treatment group. Children were assessed before and after treatment, 3, 6 months post-intervention using QUEST and Besta Scales. 105 children were recruited (39 Constraint Induced Movement Therapy, 33 Intensive Bimanual Training, 33 Standard Treatment). Constraint Induced Movement Therapy and Intensive Bimanual Training groups improved significantly hand function, showing constant increase in time. Grasp improved immediately and significantly with Constraint Induced Movement Therapy, with Bimanual Training grasp improved gradually reaching the same result. In both, spontaneous hand use increased in long-term assessment.