To Örebro University

Aim: There is evidence that modified Constraint-Induced Movement Therapy (mCIMT) has a short-term positive effect on hand function in children with unilateral cerebral palsy (CP), but the long-term effect is unknown. The aim was to investigate whether or not a single block of mCIMT (2 hours/day during 2 months) at age 2-3 years influences the course of development of bimanual hand function at about 8 years of age.

Methods: A convenience sample of 45 children (girls, n = 21) with unilateral CP and mean age 32 months was included (mCIMT group, n = 26; reference group, n = 19). Brain lesion characteristics were available for 32 children. The children were measured repeatedly with the Assisting Hand Assessment (AHA) for a mean period of 4 years and 6 months. Development curves were created and compared with a non-linear mixed effects model.

Results: Children receiving mCIMT had an upper limit of development that was 8.5 AHA units higher than the reference group (p = 0.022). When controlling for brain lesion characteristics and baseline in a subgroup of 32 children, the difference was considerably smaller and no longer significant.

Conclusion: mCIMT might have a positive impact on long-term development, but the results are inconclusive.