The impact of combined constraint-induced and bimanual arm training program on the perceived hand-use experience of children with unilateral cerebral palsy

ABSTRACT

Objective: To assess change in perceived hand-use experience following a combined bimanual with constraint intervention and to examine its relationship regarding objective hand-function among children with unilateral cerebral palsy (UCP). Methods: Twenty-six children with UCP received 6 hours of combined intervention daily for 10 days. The Children’s Hand-use Experience Questionnaire (CHEQ), Assisting Hand Assessment (AHA), and the Jebsen–Taylor Test of Hand Function (JTTHF) assessed independence and experience, bimanual and unimanual function at baseline and 3-months post-intervention. Results: Significant improvement over time was noted in AHA and in JTTHF scores. No significant difference was noted on the CHEQ. Although significant associations were noted between JTTHF and AHA results and CHEQ at 3-months post-intervention, no significant associations were noted between changed scores over time. Conclusions: Although measured hand-function and performance improved, this may not be reflected in the hand-use experience during bimanual performance following a combined program. Children’s experience merits treatment strategy implementation and investigation.

KEYWORDS:

• Bilateral
• cerebral palsy
• constraint
• hemiplegia
• perceived experience

Acknowledgments

Sincere appreciation to Professor “Anki” Ann-Christin Eliasson of the Karolinska in Sweden for the Rasch analysis and to the children and their parents for participating.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.