Improved Hand Function in Children with Cerebral Palsy with Repeat Doses of Group Based Hybrid Pediatric Constraint-Induced Movement Therapy

Abstract

The study’s aim is to analyze the improved hand function and bimanual performance with unilateral cerebral palsy (CP) from repeat doses of an augmented, group-based pediatric constraint-induced movement therapy (pCIMT) camp. Fifteen children with unilateral CP (ages 5–15 years, 9 male, 6 female, Manual Abilities Classification System (MACS) I = 3, MACS II = 11, and MACS III = 1) participated in two sessions of an annual pCIMT camp. Participants attended 10 days of camp where they received group-based training wearing a constraint for a total of 50 h, received bilateral, occupation-based activities for 10 h (60 h total) including 30 min each day on the Hocoma Armeo®Spring. The Assisting Hand Assessment (AHA) was administered pre-intervention and post-intervention. Our results discovered a mean interval dose 1 and 2 was 511 days. Dose 1 mean AHA score at baseline was 55.93 ± 12.78 and 63.07 ± 12.85 at post. Dose 2 mean AHA score as 58.13 ± 14.83 and post 66.53 ± 12.82. In conclusion, there was an overall significant bimanual functional improvement based on AHA scores that indicate, regardless of which camp session, scores improved from pre-intervention to post-intervention. There was a generalized upward trend in improved hand function of a group-based pCIMT, and diminished effects between doses were reversed with repeat doses.