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Randomized comparison trial of density and context of upper limb intensive group versus individualized occupational therapy for children with unilateral cerebral palsy.

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Randomized comparison trial of density and context of upper limb intensive group versus individualized occupational therapy for children with unilateral cerebral palsy.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Sakzewski, Leanne Miller, Laura Ziviani, Jenny Abbott, David F. Rose, Stephen Macdonell, Richard A. L. Boyd, Roslyn N.
Description	Country affiliation: Australia Author Affiliation: Sakzewski L ( Faculty of Health, Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Qld, Australia.); Miller L ( Faculty of Health, Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Qld, Australia.); Ziviani J ( School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Qld, Australia.); Abbott DF ( Brain Research Institute, Florey Neurosciences Institutes (Austin), Melbourne, Vic., Australia.); Rose S ( Department of Medicine, The University of Melbourne, Melbourne, Vic., Australia.); Macdonell RA ( CSIRO, Australian e-Health Research Centre, University of Queensland Centre for Clinical Research, Brisbane, Qld, Australia.); Boyd RN ( Brain Research Institute, Florey Neurosciences Institutes (Austin), Melbourne, Vic., Australia.)
Abstract	AIM: To determine whether short-term intensive group-based therapy combining modified constraint-induced movement therapy and bimanual therapy (hybrid-CIMT) is more effective than an equal total dose of distributed individualized occupational therapy (standard care) on upper limb motor and individualized outcomes. METHOD: Fifty-three children with unilateral cerebral palsy (69% males; mean age 7y 10mo, SD 2y 4mo; Manual Ability Classification System level I, n=24; level II, n=23) were randomly allocated, and 44 received either hybrid-CIMT (n=25) or standard care (n=19). Standard care comprised six weekly occupational therapy sessions and a 12-week home programme. Outcomes were assessed at baseline, 13 weeks, and 26 weeks after treatment. RESULTS: Groups were equivalent at baseline. Standard care achieved greater gains on satisfaction with occupational performance after intervention (estimated mean difference -1.2, 95% CI -2.2 to -0.1; p=0.04) and Assisting Hand Assessment at 26 weeks (estimated mean difference 3.1, 95% CI 0.2-6.0; p=0.04). Both groups demonstrated significant improvements in dexterity of the impaired upper limb, and bimanual and occupational performance over time. The differences between groups were not clinically meaningful. INTERPRETATION: There were no differences between the two models of therapy delivery. Group-based intensive camps may not be readily available; however, individualized standard care augmented with a home programme may offer an effective alternative but needs to be provided at a sufficient dose.
File Format	HTM / HTML
ISSN	00121622
Issue Number	6
Volume Number	57
e-ISSN	14698749
Journal	Developmental Medicine & Child Neurology
Language	English
Publisher	Wiley
Publisher Date	2015-06-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Occupational Therapy Comparative Study Humans Male Treatment Outcome Randomized Controlled Trial Journal Article Physiopathology Upper Extremity Female Discipline Pediatric Neurology Rehabilitation Cerebral Palsy Child Methods
Content Type	Text
Resource Type	Article
Subject	Neurology (clinical) Pediatrics, Perinatology and Child Health Developmental Neuroscience

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