Comparing the Effectiveness of mCIMT and Bimanual Training
Condition: Cerebral Palsy
MeSH terms: Cerebral Palsy
Study type: Interventional

Summary: 
      This study aimed to compare the effects of Modified Constraint-Induced Movement Therapy
      (mCIMT) and Bimanual Training (BIT) based on the International Classification of Functioning,
      Disability, and Health, Children &Youth (ICF-CY) conceptual framework. Our assumptions were
      that (1) mCIMT is more effective on outcomes representing all subdomains of ICF and (2) the
      possible improvements in the body structure and function, activity, and participation
      subdomains of ICF are intimately related to each other.
    

Detailed description: 
      Thirty-two children with spastic hemiplegic cerebral palsy (mean age 10.43 years [SD 2.9
      years]; 15 females, 17 males) whose functional profiles associated with Manual Ability
      Classification System, Gross Motor Function Classification System, and Communication Function
      Classification System changed between level I-III were randomly distributed to one of the
      mCIMT or BIT groups with equivalent dosing frequency and intensity (10 weeks/3 days per
      week/2.5 hours per day). Outcome measures categorized according to the domains of
      International Classification of Functioning, Disability, and Health, Children &Youth (ICF-CY)
      framework were used to document body functions, activity, and participation outcomes.
      Assessments were carried out before (T1) and after treatment (T2), and at 16 weeks
      post-intervention (T3) by a physical therapist blinded to group allocation. Before the study
      entry, informed consent was obtained from the parents. General and specific contents related
      to each intervention were delivered as individual sessions at the school (one session per
      week) or group sessions with two participants at rehabilitation centers (two sessions per
      week).
    

Intervention name(s): Modified Constraint-Induced Movement Therapy; Bimanual Training
Intervention type(s): Other; Other
Intervention description(s): Children's less affected hand was restricted through a mitt with a material sewn shut on the palmar face to promote the involved side's use, and unimanual gross and fine motor activities were practiced with the more affected hand. Besides, if the participant attempted to use his/her less affected hand as an assistive, a bandage was also used to strap less affected upper limb to the trunk. Specific activities were selected according to the deficit of interest, participant preference (on the condition of having potential effects on hand skills) and parent/guardian, or their teacher's request (e.g., drawing, painting, and eating).; BIT was administrated without any restrictive material on the non-involved upper limb, but instead, children were engaged in age-appropriate gross and fine motor bimanual activities. All targeted deficits of interest were addressed within the context of the selected activity.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Randomized controlled trial: Work consisting of a clinical trial that involves at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: upper limb; hand; bimanual training; constraint-induced movement therapy; ICF-CY; hemiplegic cerebral palsy