title: The effect of combining daily restraint with bimanual intensive therapy in children with hemiparetic cerebral palsy: a self-control study.
abstract: OBJECTIVE
  To examine the influence of combining restraint therapy with bimanual intensive therapy on the unimanual and bimanual function among children with hemiparetic cerebral palsy (CP). Included were nine children (ages 6-9 yr), with Manual Ability Classification System scores of 2-3, Gross Motor Functional Classification System 1-2;
  
  
  METHODS
  10 days, six hours per day including one hour of restraint followed by five hours of bimanual activities.
  
  
  METHODS
  One month and immediately prior to the intervention (as the control period), immediately, two months and six months post-intervention. The Assisting Hand Assessment was the primary outcome measure, along with the Jebsen-Taylor Test of Hand Function, the Jamar pinch gauge for grip and pinch, and the Pediatric Evaluation of Disability Inventory (PEDI).
  
  
  RESULTS
  No significant change was observed during the pre-intervention control period in any of the outcome measures; a significant improvement in all outcome parameters was noted after the intervention as compared to the control period. These achievements were still significantly higher than baseline values at six months post-intervention.
  
  
  CONCLUSIONS
  Children with hemiparetic CP at this level of impairment might benefit from a short daily intervention program of combining restraint with bimanual training in order to improve unimanual and bimanual function.
authors.affiliation: Alyn Hospital, Pediatric and Adolescent Rehabilitation Center, Jerusalem, Israel. mchoen@alyn.org
authors.forename: Marilyn
authors.initials: M
authors.lastname: Cohen-Holzer
authors.forename: Michal
authors.initials: M
authors.lastname: Katz-Leurer
authors.forename: Rachel
authors.initials: R
authors.lastname: Reinstein
authors.forename: Hemda
authors.initials: H
authors.lastname: Rotem
authors.forename: Shirley
authors.initials: S
authors.lastname: Meyer
mesh_terms: D002547:Cerebral Palsy / Q000150:complications / Q000534:rehabilitation*; D016009:Chi-Square Distribution; D002648:Child; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006225:Hand; D006429:Hemiplegia / Q000150:complications / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D053580:Muscle Strength / Q000502:physiology; D012149:Restraint, Physical / Q000379:methods*; D013997:Time Factors