INTERPRETATION In children with CP , h and splints may have a small benefit for upper limb skills .
However , results are diminished after splint wearing stops .
AIM The aim of this review was to determine the effectiveness of h and splinting for improving h and function in children with cerebral palsy ( CP ) and brain injury .
Randomized trial of constraint-induced movement therapy and bimanual training on activity outcomes for children with congenital hemiplegia.
AIM To determine if constraint-induced movement therapy ( CIMT ) is more effective than bimanual training ( BIM ) in improving upper limb activity outcomes for children with congenital hemiplegia in a matched-pairs r and omized trial . METHOD Sixty-three children ( mean age 10.2 , SD 2.7 , range 5 - 16 y ; 33 males , 30 females ) , 16 in Manual Ability Classification System level I , 46 level II , and 1 level III and 16 in Gross Motor Function Classification level I , 47 level II ) were r and omly allocated to either CIMT or BIM group day camps ( 60 hours over 10 days ) . The Melbourne Assessment of Unilateral Upper Limb Function assessed unimanual capacity of the impaired limb and Assisting H and Assessment evaluated bimanual coordination at baseline , 3 and 26 weeks , scored by blinded raters . RESULTS After concealed r and om allocation , there was no baseline difference between groups .  CIMT had superior outcomes compared with BIM for unimanual capacity at 26 weeks ( estimated mean difference [ EMD ] 4.4 , 95 % confidence interval [ CI ] 2.2 - 6.7 ; p < 0.001 ) . There was no other significant difference between groups post-intervention . Both groups demonstrated significant improvements in bimanual performance at 3 weeks , with gains maintained by BIM at 26 weeks ( EMD 2.3 ; 95 % CI 0.6 - 4.0 ; p = 0.008 ) . Interpretation Overall , there were only small differences between the two training approaches . CIMT yielded greater changes in unimanual capacity of the impaired upper limb compared with BIM . Results generally reflect specificity of practice , with CIMT  improving unimanual capacity and BIM improving bimanual performance . Considerable inter-individual variation in response to either intervention was evident . Future research should consider serial sequencing unimanual then BIM approaches to optimize upper limb outcomes for children with congenital hemiplegia
INTERPRETATION In children with CP , h and splints may have a small benefit for upper limb skills .
However , results are diminished after splint wearing stops .
AIM The aim of this review was to determine the effectiveness of h and splinting for improving h and function in children with cerebral palsy ( CP ) and brain injury .