title: The Influence of a Constraint and Bimanual Training Program Using a Variety of Modalities, on Upper Extremity Functions and Gait Parameters Among Children with Hemiparetic Cerebral Palsy: A Case Series.
abstract: OBJECTIVE
  To assess the influence of an intensive combined constraint and bimanual upper extremity (UE) training program using a variety of modalities including the fitness room and pool, on UE functions as well as the effects of the program on gait parameters among children with hemiparetic cerebral palsy.
  
  
  METHODS
  Ten children ages 6-10 years participated in the program for 2 weeks, 5 days per week for 6 hr each day. Data from the Assisting Hand Assessment (AHA) for bimanual function , the Jebsen-Taylor Test of Hand Function (JTTHF) for unimanual function, the six-minute walk test (6MWT), and the temporal-spatial aspects of gait using the GAITRite walkway were collected prior to, immediately post and 3-months post-intervention.
  
  
  RESULTS
  A significant improvement was noted in both unimanual as well as bimanual UE performance; A significant improvement in the 6MWT was noted, from a median of 442 meter [range: 294-558] at baseline to 466 [432-592] post intervention and 528 [425-609] after 3 months (p = .03).
  
  
  CONCLUSIONS
  Combining intensive practice in a variety of modalities, although targeting to the UE is associated with substantial improvement both in the upper as well as in the lower extremity function.
authors.affiliation: a Alyn, Occupational Therapy , Jerusalem , Israel.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Cohen-Holzer
authors.affiliation: b Alyn, Physical Therapy , Jerusalem , Israel.
authors.forename: Gilad
authors.initials: G
authors.lastname: Sorek
authors.affiliation: b Alyn, Physical Therapy , Jerusalem , Israel.
authors.forename: Simon
authors.initials: S
authors.lastname: Schless
authors.affiliation: b Alyn, Physical Therapy , Jerusalem , Israel.
authors.forename: Julie
authors.initials: J
authors.lastname: Kerem
authors.affiliation: c Tel Aviv University , Tel Aviv , Israel.
authors.forename: Michal
authors.initials: M
authors.lastname: Katz-Leurer
mesh_terms: D000704:Analysis of Variance; D002547:Cerebral Palsy / Q000175:diagnosis / Q000534:rehabilitation*; D002648:Child; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004185:Disability Evaluation; D019988:Children with Disabilities / Q000534:rehabilitation; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D020233:Gait Disorders, Neurologic / Q000534:rehabilitation*; D006801:Humans; D007557:Israel; D016015:Logistic Models; D008297:Male; D010291:Paresis / Q000503:physiopathology / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D013550:Swimming / Q000502:physiology*; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology*
keywords: Bimanual; cerebral palsy; constraint; gait; hemiplegia