Enhancing Grip Strength and Manual Dexterity in Unilateral Cerebral Palsy: A Randomized Trial of Mirror Visual Feedback vs. Modified Constraint-Induced Movement Therapy

<b>Background/Objectives</b>: Manual dexterity and hand strength are common challenges in children with unilateral cerebral palsy (UCP), limiting the use of their affected upper limb and impacting daily activities. The efficacy of a long-duration Mirror Visual Feedback (MVF) program comp...

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Main Authors: Mohamed A. Abdel Ghafar, Osama R. Abdelraouf, Nouf H. Alkhamees, Mariam E. Mohamed, Eman M. Harraz, Mohamed K. Seyam, Zizi M. Ibrahim, Amani Alnamnakani, Amal A. Elborady, Rafik E. Radwan
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Brain Sciences
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Online Access:https://www.mdpi.com/2076-3425/15/3/305
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author Mohamed A. Abdel Ghafar
Osama R. Abdelraouf
Nouf H. Alkhamees
Mariam E. Mohamed
Eman M. Harraz
Mohamed K. Seyam
Zizi M. Ibrahim
Amani Alnamnakani
Amal A. Elborady
Rafik E. Radwan
author_facet Mohamed A. Abdel Ghafar
Osama R. Abdelraouf
Nouf H. Alkhamees
Mariam E. Mohamed
Eman M. Harraz
Mohamed K. Seyam
Zizi M. Ibrahim
Amani Alnamnakani
Amal A. Elborady
Rafik E. Radwan
author_sort Mohamed A. Abdel Ghafar
collection DOAJ
description <b>Background/Objectives</b>: Manual dexterity and hand strength are common challenges in children with unilateral cerebral palsy (UCP), limiting the use of their affected upper limb and impacting daily activities. The efficacy of a long-duration Mirror Visual Feedback (MVF) program compared to Modified Constraint-Induced Movement Therapy (mCIMT) in addressing these issues remains unreported. This study was conducted to compare the efficacy of mCIMT and MVF in improving manual dexterity and hand strength in children with UCP. <b>Methods</b>: Fifty children with UCP (aged 5–9 years) were randomly assigned to either the MVF or mCIMT group. Children in both groups received their respective interventions for 30 min, five times per week, over 12 weeks. Additionally, all participants underwent traditional physical therapy for 12 weeks, three times per week, with each session lasting 45 to 60 min. Manual dexterity was assessed using the Box and Block Test (BBT), and maximum isometric hand strength was measured with a hydraulic handheld dynamometer. Evaluations were conducted before the intervention and 12 weeks later. <b>Results</b>: Repeated measures of MANOVA revealed significant enhancements in manual dexterity and hand strength in both groups after the intervention. However, the mCIMT group demonstrated significantly greater gains in BBT scores (<i>p</i> = 0.014) and maximum isometric hand strength (<i>p</i> = 0.017) compared to the MVF group, with effect sizes of <b>0.75 and 0.79,</b> respectively. <b>Conclusions</b>: Incorporating either mCIMT or MVF into rehabilitation significantly enhances manual dexterity and hand strength in children with UCP, with mCIMT yielding superior outcomes.
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spelling doaj-art-313c0f149fb1420abc9635b5ff02f7c22025-08-20T02:11:25ZengMDPI AGBrain Sciences2076-34252025-03-0115330510.3390/brainsci15030305Enhancing Grip Strength and Manual Dexterity in Unilateral Cerebral Palsy: A Randomized Trial of Mirror Visual Feedback vs. Modified Constraint-Induced Movement TherapyMohamed A. Abdel Ghafar0Osama R. Abdelraouf1Nouf H. Alkhamees2Mariam E. Mohamed3Eman M. Harraz4Mohamed K. Seyam5Zizi M. Ibrahim6Amani Alnamnakani7Amal A. Elborady8Rafik E. Radwan9Physical Therapy Program, Batterjee Medical College, Jeddah 21442, Saudi ArabiaPhysical Therapy Program, Batterjee Medical College, Jeddah 21442, Saudi ArabiaDepartment of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi ArabiaPhysical Therapy Program, Batterjee Medical College, Jeddah 21442, Saudi ArabiaDepartment of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Mansoura University, Mansoura 35516, EgyptDepartment of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al-Majmaah 11952, Saudi ArabiaDepartment of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi ArabiaOccupational Therapy Program, Batterjee Medical College, Jeddah 21442, Saudi ArabiaDepartment of Biomechanics, Faculty of Physical Therapy, Cairo University, Giza 12613, EgyptDepartment of Biomechanics, Faculty of Physical Therapy, Cairo University, Giza 12613, Egypt<b>Background/Objectives</b>: Manual dexterity and hand strength are common challenges in children with unilateral cerebral palsy (UCP), limiting the use of their affected upper limb and impacting daily activities. The efficacy of a long-duration Mirror Visual Feedback (MVF) program compared to Modified Constraint-Induced Movement Therapy (mCIMT) in addressing these issues remains unreported. This study was conducted to compare the efficacy of mCIMT and MVF in improving manual dexterity and hand strength in children with UCP. <b>Methods</b>: Fifty children with UCP (aged 5–9 years) were randomly assigned to either the MVF or mCIMT group. Children in both groups received their respective interventions for 30 min, five times per week, over 12 weeks. Additionally, all participants underwent traditional physical therapy for 12 weeks, three times per week, with each session lasting 45 to 60 min. Manual dexterity was assessed using the Box and Block Test (BBT), and maximum isometric hand strength was measured with a hydraulic handheld dynamometer. Evaluations were conducted before the intervention and 12 weeks later. <b>Results</b>: Repeated measures of MANOVA revealed significant enhancements in manual dexterity and hand strength in both groups after the intervention. However, the mCIMT group demonstrated significantly greater gains in BBT scores (<i>p</i> = 0.014) and maximum isometric hand strength (<i>p</i> = 0.017) compared to the MVF group, with effect sizes of <b>0.75 and 0.79,</b> respectively. <b>Conclusions</b>: Incorporating either mCIMT or MVF into rehabilitation significantly enhances manual dexterity and hand strength in children with UCP, with mCIMT yielding superior outcomes.https://www.mdpi.com/2076-3425/15/3/305mirror visual feedbackconstraint-induced movement therapyhand dexterityunilateral cerebral palsy
spellingShingle Mohamed A. Abdel Ghafar
Osama R. Abdelraouf
Nouf H. Alkhamees
Mariam E. Mohamed
Eman M. Harraz
Mohamed K. Seyam
Zizi M. Ibrahim
Amani Alnamnakani
Amal A. Elborady
Rafik E. Radwan
Enhancing Grip Strength and Manual Dexterity in Unilateral Cerebral Palsy: A Randomized Trial of Mirror Visual Feedback vs. Modified Constraint-Induced Movement Therapy
Brain Sciences
mirror visual feedback
constraint-induced movement therapy
hand dexterity
unilateral cerebral palsy
title Enhancing Grip Strength and Manual Dexterity in Unilateral Cerebral Palsy: A Randomized Trial of Mirror Visual Feedback vs. Modified Constraint-Induced Movement Therapy
title_full Enhancing Grip Strength and Manual Dexterity in Unilateral Cerebral Palsy: A Randomized Trial of Mirror Visual Feedback vs. Modified Constraint-Induced Movement Therapy
title_fullStr Enhancing Grip Strength and Manual Dexterity in Unilateral Cerebral Palsy: A Randomized Trial of Mirror Visual Feedback vs. Modified Constraint-Induced Movement Therapy
title_full_unstemmed Enhancing Grip Strength and Manual Dexterity in Unilateral Cerebral Palsy: A Randomized Trial of Mirror Visual Feedback vs. Modified Constraint-Induced Movement Therapy
title_short Enhancing Grip Strength and Manual Dexterity in Unilateral Cerebral Palsy: A Randomized Trial of Mirror Visual Feedback vs. Modified Constraint-Induced Movement Therapy
title_sort enhancing grip strength and manual dexterity in unilateral cerebral palsy a randomized trial of mirror visual feedback vs modified constraint induced movement therapy
topic mirror visual feedback
constraint-induced movement therapy
hand dexterity
unilateral cerebral palsy
url https://www.mdpi.com/2076-3425/15/3/305
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