CIMT and BIMT Affect Functional Outcome in CP
Condition: Cerebral Palsy, Congenital
MeSH terms: Cerebral Palsy
Study type: Interventional

Summary: 
      The aim of this randomized controlled trial is to determine the effects of constraint induced
      movement therapy CIMT and BIM bimanual activities on functional outcome in hemiplegic CP. Two
      randomized groups of patients with CP are treated with constrained arm for three hours on
      affected side and bimanual activities on BIM group respectively. Both, male and female
      patients meeting the inclusion criteria will be included. Patients having concurrent
      malignancy, infection, trauma or any bony deformity will be excluded.
    

Detailed description: 
      It is a Randomized control trial. Cerebral palsy children of age groups of 5 yrs to 12 years
      were included in the study with total sample size of thirty eight (38) with confidence
      interval of 95%. Simple random sampling was done by lottery method and data was collected
      from ALFARABI special school of education Islamabad. Two groups were formed and named as
      group A; CIMT with nineteen participants and group B, BIM bimanual training with nineteen
      participants respectively. The RCT compared the functional outcome of 3 hours constraining
      for 3 times a week for 6 weeks duration for CIMT group and five bimanual activities performed
      for three hours a day for bimanual group B and were assessed on the pretest and post test
      score evaluation of QUEST and JTHF test. All the participants were hemiplegic cp from both
      gender, fall on MAC system level II. Treatment for three hours was done on alternate days for
      3 days a week. Five bimanual activites of holding a tray, cutting a fruit with knife,
      buttoning, cutting paper with scissor, and carry heavy objects with both hands are applied.
      Whereas the activities performed in CIMT are brushing teeth, holding spoon, fork combing hair
      and writing. Forty five children were screened before the evaluation and as a result 38 were
      enrolled in both groups having 19 in each group.
    

Intervention name(s): Constraint induced movement therapy; Bimanual activities
Intervention type(s): Other; Other
Intervention description(s): Constrained on more affected side for three hours. To minimize the learned non use in hemiplegic CIMT is applied and criteria of applying CIMT is;
10 degrees active wrist extension on the affected hand,
10 degrees active thumb abduction,
10 º active extension of any two digits on the side or hand which is limited due to damage.
In order to gain the maximum good results from CIMT technique following points should also be considered attentively. Affected arm should move to 45 degrees shoulder flexion and abduction, and 90 degrees of elbow flexion and extension.
Constrained with cotton sling. 3 to 5 upper limb functional activities like
using fork or a spoon,
combing hair
brushing teeth
writing
dressing all activities are performed for 10 t0 15 minutes in period of three hours on alternate days in a week; Bimanual activities of both hands are performed like
Set of bimanual activities is used to assess the bimanual hand function. Five bimanual activities are performed such as
carrying a tray,
cutting a fruit with a knife,
holding and cutting the paper with scissor,
buttoning and
Carrying heavy objects with both hands.
Every activity was performed for 10 t0 15 minutes on alternate days for a period of 6 weeks session.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Cerebral Palsy; Neurorehabilitation; Spasticity