Forced use as a home-based intervention in children with congenital hemiplegic cerebral palsy: choosing the appropriate constraint.
OBJECTIVE
The purpose of this study was (1) to identify the most appropriate splint from children's and parents' perspective as reflected by effectiveness and adherence to home-based forced use therapy (FUT). (2) To provide guidance in the development of a practical and effective protocol based on forced use principles.


METHODS
A crossover design with a convenience sample of children with hemiplegic cerebral palsy and their parents was used to test three types of splint (mitt, short splint and long splint) during home-based FUT. Children wore the splints for a minimum of 1 h/ day during physical activity. Outcome measures included a daily log and a questionnaire (completed by parents), an actometer worn on the affected hand to quantify movement and video recordings to inform quality of movement.


RESULTS
The short splint was found to be the most effective and acceptable restraining device. Wearing devices for more than 1 h per day was not considered acceptable by either parents or children.


CONCLUSIONS
A short splint, worn for 1 h per day was found to be the most acceptable protocol.
Psychouli
Pavlina
P
School of Health Professions and Rehabilitation Sciences, University of Southampton, Highfield Campus, Building 45, Southampton, UK. pp8@soton.ac.uk
Burridge
Jane
J
Kennedy
Colin
C
D002547:Cerebral Palsy / Q000150:complications / Q000151:congenital / Q000534:rehabilitation*; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D018592:Cross-Over Studies; D004867:Equipment Design; D004869:Equipment Safety; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006429:Hemiplegia / Q000151:congenital / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D007103:Immobilization / Q000379:methods; D008297:Male; D010287:Parent-Child Relations; D010349:Patient Compliance / Q000706:statistics & numerical data*; D018570:Risk Assessment; D013165:Splints / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013997:Time Factors; D006113:United Kingdom; D034941:Upper Extremity