Intensive goal-directed upper limb training programs using either constraint-induced movement therapy (CIMT) or bimanual training (BIM) achieved domain-specific changes in quality of life relating to feelings about functioning and participation and physical health in children with unilateral cerebral palsy (CP), say authors of an article published online in Developmental Medicine and Child Neurology. A condition-specific quality of life measure compared with a generic measure may be better able to detect changes in quality of life in children with unilateral CP, they add.
Researchers randomly assigned 63 children (mean age 10 years 2 months [SD 2 years 6 months]; 33 boys, 30 girls) with CP of the spastic motor type (n=59) or with spasticity and dystonia (n=4) to 2 groups. The children were assessed as Manual Ability Classification System level I (n=16), II (n=46), or III (n=1). Each group received 6 hours of daily intervention (either CIMT or BIM) for 10 days over a 2-week period (total intervention time 60 hours). Children aged 9 years and older completed the Cerebral Palsy Quality of Life Questionnaire for Children (CPQOL-Child), and those aged 8 years and older completed the KIDSCREEN-52. All parents completed proxy versions of each measure. Assessments were made at baseline and at 3, 26, and 52 weeks after the end of the intervention.
Thirty-five children completed the CPQOL-Child and 41 completed the KIDSCREEN-52. No changes in social or emotional well-being were reported by children in either group. Children and parents from both groups reported a significant improvement in their or their child's feelings about functioning as well as participation and physical health on the CPQOL-Child. The parents of children receiving CIMT reported positive and sustained changes in their child's social well-being (CPQOL-Child). The CIMT group showed significant improvements in physical well-being, psychological well-being, and moods and emotions (KIDSCREEN-52) at 3 weeks post intervention, which were maintained over the study period.