Constraint-Induced Movement Therapy Versus Bimanual Training to Improve Upper Limb Function in Cerebral Palsy: A Systematic Review and Meta-Analysis of Follow-Ups
<b>Background/Objectives</b>: Constraint-induced movement therapy (CIMT) and bimanual training (BIT) have been commonly used to improve upper limb (ULF) in paediatric populations. This study aimed to compare the efficacy of CIMT and BIT for the recovery of ULF in youth with unilateral ce...
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MDPI AG
2025-06-01
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| Online Access: | https://www.mdpi.com/2227-9067/12/6/804 |
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| author | Gabriel Martin-Moreno Marta Moreno-Ligero Alejandro Salazar David Lucena-Anton Jose A. Moral-Munoz |
| author_facet | Gabriel Martin-Moreno Marta Moreno-Ligero Alejandro Salazar David Lucena-Anton Jose A. Moral-Munoz |
| author_sort | Gabriel Martin-Moreno |
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| description | <b>Background/Objectives</b>: Constraint-induced movement therapy (CIMT) and bimanual training (BIT) have been commonly used to improve upper limb (ULF) in paediatric populations. This study aimed to compare the efficacy of CIMT and BIT for the recovery of ULF in youth with unilateral cerebral palsy (CP) in the immediate, short, and long term. <b>Methods</b>: A systematic review with a meta-analysis of randomised controlled trials (RCTs) from the PubMed/Medline, Scopus, Web of Science, and PEDro databases was conducted. The primary outcomes were the immediate, short-, and long-term effects on ULF, and the secondary outcomes were related to occupational performance and disability. The risk of bias was assessed using the Cochrane RoB 2.0 tool by two researchers independently. Meta-analyses were performed using RevMan 5.3. <b>Results</b>: From the 174 records obtained, 10 RTCs comprising 418 participants were included. Favourable results were observed immediately after intervention for CIMT regarding unimanual ULF using the Quality of Upper Extremity Test (QUEST) (SMD = 1.08; 95% CI = (0.66;1.50)) and Jebsen–Taylor Hand Function Test (JTHFT) (SMD = −0.62; 95% CI = (−1.23;0.00)). These results were maintained in the short term for the QUEST for dissociated movements (SMD = 1.19; 95% CI = (0.40;1.99)) and in the long term for the JTHFT (SMD = −0.38; 95% CI = (−1;0.24)). Conversely, favourable results were obtained immediately after the intervention for BIT regarding bimanual ULF using the Assisting Hand Assessment (SMD = −0.42; 95% CI = (−0.78–0.05)). <b>Conclusions</b>: CIMT could be more effective for improving unimanual ULF and BIT in youth with unilateral CP. The differences between the interventions decreased in the long term. Nevertheless, these findings should be interpreted with caution due to the variability in the intervention programmes. Further research with standardised protocols is needed. |
| format | Article |
| id | doaj-art-67cf225f32184d69b3dfc36aaaf4811f |
| institution | OA Journals |
| issn | 2227-9067 |
| language | English |
| publishDate | 2025-06-01 |
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| series | Children |
| spelling | doaj-art-67cf225f32184d69b3dfc36aaaf4811f2025-08-20T02:24:42ZengMDPI AGChildren2227-90672025-06-0112680410.3390/children12060804Constraint-Induced Movement Therapy Versus Bimanual Training to Improve Upper Limb Function in Cerebral Palsy: A Systematic Review and Meta-Analysis of Follow-UpsGabriel Martin-Moreno0Marta Moreno-Ligero1Alejandro Salazar2David Lucena-Anton3Jose A. Moral-Munoz4Department of Nursing and Physiotherapy, University of Cadiz, 11009 Cádiz, SpainDepartment of Nursing and Physiotherapy, University of Cadiz, 11009 Cádiz, SpainDepartment of Statistics and Operational Research, University of Cadiz, 11510 Puerto Real, SpainDepartment of Nursing and Physiotherapy, University of Cadiz, 11009 Cádiz, SpainDepartment of Nursing and Physiotherapy, University of Cadiz, 11009 Cádiz, Spain<b>Background/Objectives</b>: Constraint-induced movement therapy (CIMT) and bimanual training (BIT) have been commonly used to improve upper limb (ULF) in paediatric populations. This study aimed to compare the efficacy of CIMT and BIT for the recovery of ULF in youth with unilateral cerebral palsy (CP) in the immediate, short, and long term. <b>Methods</b>: A systematic review with a meta-analysis of randomised controlled trials (RCTs) from the PubMed/Medline, Scopus, Web of Science, and PEDro databases was conducted. The primary outcomes were the immediate, short-, and long-term effects on ULF, and the secondary outcomes were related to occupational performance and disability. The risk of bias was assessed using the Cochrane RoB 2.0 tool by two researchers independently. Meta-analyses were performed using RevMan 5.3. <b>Results</b>: From the 174 records obtained, 10 RTCs comprising 418 participants were included. Favourable results were observed immediately after intervention for CIMT regarding unimanual ULF using the Quality of Upper Extremity Test (QUEST) (SMD = 1.08; 95% CI = (0.66;1.50)) and Jebsen–Taylor Hand Function Test (JTHFT) (SMD = −0.62; 95% CI = (−1.23;0.00)). These results were maintained in the short term for the QUEST for dissociated movements (SMD = 1.19; 95% CI = (0.40;1.99)) and in the long term for the JTHFT (SMD = −0.38; 95% CI = (−1;0.24)). Conversely, favourable results were obtained immediately after the intervention for BIT regarding bimanual ULF using the Assisting Hand Assessment (SMD = −0.42; 95% CI = (−0.78–0.05)). <b>Conclusions</b>: CIMT could be more effective for improving unimanual ULF and BIT in youth with unilateral CP. The differences between the interventions decreased in the long term. Nevertheless, these findings should be interpreted with caution due to the variability in the intervention programmes. Further research with standardised protocols is needed.https://www.mdpi.com/2227-9067/12/6/804cerebral palsyconstraint-induced movement therapybimanual therapyupper limb function |
| spellingShingle | Gabriel Martin-Moreno Marta Moreno-Ligero Alejandro Salazar David Lucena-Anton Jose A. Moral-Munoz Constraint-Induced Movement Therapy Versus Bimanual Training to Improve Upper Limb Function in Cerebral Palsy: A Systematic Review and Meta-Analysis of Follow-Ups Children cerebral palsy constraint-induced movement therapy bimanual therapy upper limb function |
| title | Constraint-Induced Movement Therapy Versus Bimanual Training to Improve Upper Limb Function in Cerebral Palsy: A Systematic Review and Meta-Analysis of Follow-Ups |
| title_full | Constraint-Induced Movement Therapy Versus Bimanual Training to Improve Upper Limb Function in Cerebral Palsy: A Systematic Review and Meta-Analysis of Follow-Ups |
| title_fullStr | Constraint-Induced Movement Therapy Versus Bimanual Training to Improve Upper Limb Function in Cerebral Palsy: A Systematic Review and Meta-Analysis of Follow-Ups |
| title_full_unstemmed | Constraint-Induced Movement Therapy Versus Bimanual Training to Improve Upper Limb Function in Cerebral Palsy: A Systematic Review and Meta-Analysis of Follow-Ups |
| title_short | Constraint-Induced Movement Therapy Versus Bimanual Training to Improve Upper Limb Function in Cerebral Palsy: A Systematic Review and Meta-Analysis of Follow-Ups |
| title_sort | constraint induced movement therapy versus bimanual training to improve upper limb function in cerebral palsy a systematic review and meta analysis of follow ups |
| topic | cerebral palsy constraint-induced movement therapy bimanual therapy upper limb function |
| url | https://www.mdpi.com/2227-9067/12/6/804 |
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