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Updated: Aug 15, 2026
Robotic Mirror Therapy System for Functional Recovery of Hemiplegic Arms
Published on: August 15, 2016
Efficacy of forced-use therapy in hemiplegic cerebral palsy
In-Young Sung1, Ju-Seok Ryu, Sung-Bom Pyun
1Department of Physical Medicine and Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. iysung@amc.seoul.kr
Insights
Forced-use therapy (FUT) significantly improved upper-extremity function in children with hemiplegic cerebral palsy (CP). This therapy, combined with conventional rehabilitation, showed better results than rehabilitation alone for affected hand function.
Area of Science:
- Pediatric Rehabilitation
- Neurology
- Occupational Therapy
Background:
- Hemiplegic cerebral palsy (CP) significantly impacts upper-extremity function in children.
- Conventional rehabilitation programs offer some benefits but may not fully restore hand function.
Purpose of the Study:
- To evaluate the efficacy of forced-use therapy (FUT) in enhancing upper-extremity function in pediatric hemiplegic CP.
- To compare the outcomes of FUT combined with conventional therapy versus conventional therapy alone.
Main Methods:
- A prospective case series design was employed with 31 children diagnosed with hemiplegic CP.
- Participants were divided into a FUT group (n=18) and a control group (n=13).
- The FUT group received conventional rehabilitation plus a 6-week short-arm cast on the unaffected arm; the control group received conventional rehabilitation only.
Main Results:
- Pre-treatment, no significant differences were observed between the groups in hand function tests (Box and Block Test, Erhardt Developmental Prehension Assessment, WeeFIM).
- Post-treatment, the FUT group demonstrated significant improvements in the affected arm's Box and Block Test and Erhardt Developmental Prehension Assessment scores (P<.05).
- The WeeFIM self-care scores also showed significant improvement in the FUT group compared to the control group (P<.05).
Conclusions:
- Forced-use therapy, when integrated with conventional rehabilitation, is more effective for improving affected hand function in children with hemiplegic CP.
- FUT offers a promising therapeutic approach to enhance motor outcomes in this population.
- Further research may explore long-term effects and optimal application protocols for FUT in pediatric CP.
Objective:
To determine the efficacy of forced-use therapy (FUT) on the improvement of upper-extremity function in children with hemiplegic cerebral palsy (CP).
Design:
Prospective case series.
Setting:
Outpatient ambulatory clinic in South Korea.
Participants:
Thirty-one patients with hemiplegic CP were assigned to the FUT group (n=18) or to the control group (n=13). The mean age of the patients in the FUT group was 33.2 months and in the control group it was 43.2 months.
Interventions:
The FUT group wore a short-arm Scotchcast on the unaffected arm for 6 weeks and also participated in a conventional rehabilitation program that included stretching exercises and functional occupational therapy for the upper extremity. The control group underwent the conventional rehabilitation program only.
Main Outcome Measure:
Hand function tests, including the box and block test (BBT), Erhardt Developmental Prehension Assessment (EDPA), and WeeFIM instrument taken before and after 6 weeks of treatment.
Results:
Before treatment, there was no significant difference between groups in the BBT, EDPA, and WeeFIM scores. After 6 weeks of treatment, however, the FUT group showed significant improvement in the affected arm in the BBT and EDPA scores, compared with the control group (P<.05). The self-care score on the WeeFIM was also significantly improved in the FUT group (P<.05).
Conclusions:
FUT combined with a conventional rehabilitation program appears to be more effective than a rehabilitation program alone in improving affected hand function in children with hemiplegic CP.
