The Influence of Intense Combined Training on Upper Extremity Function in Children With Unilateral Cerebral Palsy:...

Area of Science:

• Pediatrics
• Rehabilitation Medicine
• Neuroscience

Background:

• Unilateral cerebral palsy (UCP) affects arm and hand function.
• Manual ability, classified by the Manual Ability Classification System (MACS), varies among children with UCP.
• Intensive training programs aim to improve arm functioning in children with UCP.

Purpose of the Study:

• To investigate if manual ability level influences the effectiveness of a combined modified constraint and bimanual training program.
• To assess the impact of the intervention on arm functioning in children with UCP across different MACS levels.

Main Methods:

• A 2-week intensive program combining modified constraint and bimanual training was administered.
• Thirty-four children (aged 6-11) with MACS levels I-III participated.
• The Assisting Hand Assessment (AHA) and Jebsen-Taylor Test of Hand Function (JTTHF) were used for pre-, post-, and follow-up assessments.

Main Results:

• Overall improvement in bimanual abilities (AHA scores) was observed over time.
• No significant differences in bimanual improvement were found between MACS levels.
• While bimanual skills improved across all levels, only children in MACS level III showed significant improvement in unilateral skills of the less-affected hand.

Conclusions:

• The intensive program improved bimanual abilities in children with UCP regardless of their manual ability level.
• Children with lower manual ability (MACS level III) experienced greater improvements in unilateral arm function compared to those with higher manual ability (MACS levels I and II).
• Manual ability level is a key factor in predicting response to specific aspects of arm training in UCP.