Functional impact of constraint therapy and bimanual training in children with cerebral palsy: a randomized controlled trial.

OBJECTIVE We compared children's self-care performance and caregivers' perception of children's performance on functional goals established for children with hemiplegic cerebral palsy (CP) after unimanual constraint-induced movement therapy (CIMT) or hand-arm bimanual intensive training (HABIT). METHOD Sixteen children with CP were randomized to the CIMT or HABIT group. Interventions lasted for 15 days, 6 hr/day, totaling 90 hr. We used the Pediatric Evaluation of Disability Inventory and the Canadian Occupational Performance Measure (COPM) to assess the children's daily functioning and mixed analyses of variance to compare group means on functional test scores before and after intervention. RESULTS Both groups showed significant improvements on functional measures. Group × Assessment interaction in COPM performance revealed greater improvements for the HABIT group after intervention (p = .04). CONCLUSION The results suggest that specificity of training exists only for performance of specific goals established by parents and that both CIMT and HABIT can be used to increase children's daily functioning.