Effect of forced use therapy on posture in children with hemiplegic cerebral palsy: a pilot study.

OBJECTIVE To evaluate the impact of forced use therapy on posture in children with hemiplegic cerebral palsy. DESIGN Single group pre- and post-training assessments. SUBJECTS Eight children (mean age 10.5 years (standard deviation 1.26 years)) with hemiplegic cerebral palsy Levels I and II on the gross motor function classification scale. METHODS All participants underwent 12 days (6 h/day) of forced use therapy. Postural asymmetry as well as the centre of pressure range and peak velocity during quiet standing were evaluated before and after the therapy. Upper limb functional level was also assessed using the Bruininks Oseretsky test of Motor Proficiency and the Assisting Hand Assessment. RESULTS Before forced use therapy, postural asymmetry tended to decrease when the participants wore the upper limb constraint. After forced use therapy, upper limb functional scores improved significantly, and postural asymmetry tended to decrease, compared with the pre-therapy values. Postural improvement was correlated with postural asymmetry before forced use therapy. No significant differences were observed on the centre of pressure displacement parameters during the quiet standing tests in all conditions. CONCLUSION This pilot study showed that forced use therapy may be an efficient way to improve postural asymmetry in children with hemiplegic cerebral palsy.